How much rates vary
Facilitymedian $5 · 10th to 90th $3 to $10Professionalmedian $3 · 10th to 90th $3 to $39
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 $2.95 Median $2.95 Typical High $7.41 | Facility | None | $2.95 | $2.95 | $7.41 |
Aetna Setting Professional Modifier None Typical Low $2.88 Median $2.95 Typical High $125.89 | Professional | None | $2.88 | $2.95 | $125.89 |
Anthem BCBS Setting Facility Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Facility | None | $3.63 | $3.63 | $3.63 |
Anthem BCBS Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $4.37 | Professional | None | $2.88 | $2.88 | $4.37 |
CareSource Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $4.79 | Professional | None | $3.16 | $3.16 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $4.47 Median $8.71 Typical High $10.00 | Facility | None | $4.47 | $8.71 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $6.46 | Professional | None | $2.88 | $2.88 | $6.46 |
DeanCare Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $154.88 | Facility | None | $3.16 | $3.16 | $154.88 |
DeanCare Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $10.96 | Professional | None | $3.16 | $3.16 | $10.96 |
Medica Setting Facility Modifier None Typical Low $2.95 Median $5.25 Typical High $24.55 | Facility | None | $2.95 | $5.25 | $24.55 |
Medica Setting Professional Modifier None Typical Low $2.95 Median $38.02 Typical High $501.19 | Professional | None | $2.95 | $38.02 | $501.19 |
Network Health Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Network Health Setting Professional Modifier None Typical Low $3.02 Median $3.39 Typical High $3.47 | Professional | None | $3.02 | $3.39 | $3.47 |
Prevea360 Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $154.88 | Facility | None | $3.16 | $3.16 | $154.88 |
Prevea360 Setting Professional Modifier None Typical Low $4.68 Median $6.31 Typical High $6.31 | Professional | None | $4.68 | $6.31 | $6.31 |
Quartz Setting Professional Modifier None Typical Low $2.88 Median $5.37 Typical High $10.47 | Professional | None | $2.88 | $5.37 | $10.47 |
Quartz Setting Facility Modifier None Typical Low $4.79 Median $8.71 Typical High $8.71 | Facility | None | $4.79 | $8.71 | $8.71 |
Quartz Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Security Health Setting Professional Modifier None Typical Low $3.89 Median $5.89 Typical High $7.41 | Professional | None | $3.89 | $5.89 | $7.41 |
The Alliance Setting Professional Modifier None Typical Low $3.89 Median $7.59 Typical High $9.77 | Professional | None | $3.89 | $7.59 | $9.77 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.55 Typical High $38.90 | Professional | None | $3.24 | $3.55 | $38.90 |
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 $1.45 Median $1.48 Typical High $123.03 | Professional | 52 · Reduced service | $1.45 | $1.48 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.58 Median $0.59 Typical High $50.12 | Professional | 53 · Discontinued | $0.58 | $0.59 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.45 Typical High $37.15 | Professional | 55 · Aftercare only | $0.44 | $0.45 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.30 Typical High $24.55 | Professional | 56 · Pre-op care only | $0.28 | $0.30 | $24.55 |
Where Wisconsin sits
The same service costs 3.5 times more in Wyoming than in Ohio. 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· 15th of 51
$3.24
WY $10.00OH $2.88
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.