How much rates vary
Facilitymedian $16 · 10th to 90th $9 to $25Professionalmedian $9 · 10th to 90th $8 to $15
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $19.95 | Facility | None | $8.51 | $8.51 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.51 Typical High $11.48 | Professional | None | $8.13 | $8.51 | $11.48 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.23 Median $10.23 Typical High $18.62 | Facility | None | $10.23 | $10.23 | $18.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $12.30 | Professional | None | $8.13 | $8.13 | $12.30 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $18.20 Typical High $25.12 | Facility | None | $12.59 | $18.20 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $15.14 | Professional | None | $8.13 | $8.13 | $15.14 |
DeanCare Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $23.44 | Facility | None | $10.72 | $10.72 | $23.44 |
DeanCare Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $23.44 | Professional | None | $12.30 | $12.30 | $23.44 |
Medica Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $21.38 | Facility | None | $9.77 | $9.77 | $21.38 |
Medica Setting Professional Modifier None Typical Low $9.77 Median $10.72 Typical High $14.45 | Professional | None | $9.77 | $10.72 | $14.45 |
Network Health Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $24.55 | Facility | None | $16.60 | $16.60 | $24.55 |
Network Health Setting Professional Modifier None Typical Low $11.75 Median $13.18 Typical High $14.45 | Professional | None | $11.75 | $13.18 | $14.45 |
Prevea360 Setting Facility Modifier None Typical Low $10.72 Median $10.72 Typical High $23.44 | Facility | None | $10.72 | $10.72 | $23.44 |
Prevea360 Setting Professional Modifier None Typical Low $15.85 Median $21.38 Typical High $21.38 | Professional | None | $15.85 | $21.38 | $21.38 |
Quartz Setting Professional Modifier None Typical Low $8.13 Median $16.98 Typical High $39.81 | Professional | None | $8.13 | $16.98 | $39.81 |
Quartz Setting Facility Modifier None Typical Low $13.49 Median $25.12 Typical High $25.12 | Facility | None | $13.49 | $25.12 | $25.12 |
Quartz Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Security Health Setting Professional Modifier None Typical Low $10.96 Median $21.88 Typical High $29.51 | Professional | None | $10.96 | $21.88 | $29.51 |
The Alliance Setting Professional Modifier None Typical Low $13.80 Median $26.92 Typical High $60.26 | Professional | None | $13.80 | $26.92 | $60.26 |
United Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $8.71 Median $9.55 Typical High $11.75 | Professional | None | $8.71 | $9.55 | $11.75 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.17 Median $4.27 Typical High $64.57 | Professional | 52 · Reduced service | $4.17 | $4.27 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.70 Typical High $25.70 | Professional | 53 · Discontinued | $1.66 | $1.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.26 Typical High $19.05 | Professional | 55 · Aftercare only | $1.23 | $1.26 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.83 Median $0.83 Typical High $12.88 | Professional | 56 · Pre-op care only | $0.83 | $0.83 | $12.88 |
Where Wisconsin sits
The same service costs 1.9 times more in Wyoming than in Georgia. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Wisconsin· 18th of 51
$8.71
WY $15.49GA $8.13
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.