How much rates vary
Facilitymedian $9 · 10th to 90th $6 to $17Professionalmedian $6 · 10th to 90th $5 to $20
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 $5.89 Median $5.89 Typical High $13.18 | Facility | None | $5.89 | $5.89 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $5.75 Median $5.89 Typical High $22.91 | Professional | None | $5.75 | $5.89 | $22.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $10.72 Median $11.48 Typical High $12.88 | Facility | None | $10.72 | $11.48 | $12.88 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $14.45 | Professional | None | $5.37 | $5.37 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $8.51 Median $14.13 Typical High $16.98 | Facility | None | $8.51 | $14.13 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $10.23 | Professional | None | $5.50 | $5.50 | $10.23 |
DeanCare Setting Facility Modifier None Typical Low $5.25 Median $5.75 Typical High $12.88 | Facility | None | $5.25 | $5.75 | $12.88 |
DeanCare Setting Professional Modifier None Typical Low $6.31 Median $6.31 Typical High $11.48 | Professional | None | $6.31 | $6.31 | $11.48 |
Medica Setting Facility Modifier None Typical Low $5.25 Median $5.75 Typical High $12.88 | Facility | None | $5.25 | $5.75 | $12.88 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $6.76 Typical High $25.12 | Professional | None | $5.75 | $6.76 | $25.12 |
Network Health Setting Facility Modifier None Typical Low $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Network Health Setting Professional Modifier None Typical Low $6.03 Median $6.76 Typical High $7.24 | Professional | None | $6.03 | $6.76 | $7.24 |
Prevea360 Setting Facility Modifier None Typical Low $5.25 Median $5.75 Typical High $12.88 | Facility | None | $5.25 | $5.75 | $12.88 |
Prevea360 Setting Professional Modifier None Typical Low $8.51 Median $11.48 Typical High $11.48 | Professional | None | $8.51 | $11.48 | $11.48 |
Quartz Setting Professional Modifier None Typical Low $5.89 Median $10.23 Typical High $14.45 | Professional | None | $5.89 | $10.23 | $14.45 |
Quartz Setting Facility Modifier None Typical Low $9.12 Median $16.98 Typical High $16.98 | Facility | None | $9.12 | $16.98 | $16.98 |
Quartz Setting Professional Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Professional | None | $5.50 | $5.50 | $5.50 |
Security Health Setting Professional Modifier None Typical Low $6.31 Median $7.76 Typical High $8.91 | Professional | None | $6.31 | $7.76 | $8.91 |
United Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
United Setting Professional Modifier None Typical Low $5.75 Median $6.31 Typical High $7.24 | Professional | None | $5.75 | $6.31 | $7.24 |
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 $2.88 Median $2.95 Typical High $11.48 | Professional | 52 · Reduced service | $2.88 | $2.95 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.17 Typical High $4.57 | Professional | 53 · Discontinued | $1.15 | $1.17 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $0.89 Typical High $3.47 | Professional | 55 · Aftercare only | $0.85 | $0.89 | $3.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.59 Typical High $2.29 | Professional | 56 · Pre-op care only | $0.56 | $0.59 | $2.29 |
Where Wisconsin sits
The same service costs 1.5 times more in Alaska than in Pennsylvania. 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· 13th of 51
$5.89
AK $8.51PA $5.50
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.