How much rates vary
Facilitymedian $8 · 10th to 90th $4 to $13Professionalmedian $4 · 10th to 90th $4 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 $4.47 Median $4.47 Typical High $11.48 | Facility | None | $4.47 | $4.47 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.47 Typical High $4.47 | Professional | None | $4.27 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $0.87 Typical High $25.12 | Professional | 53 · Discontinued | $0.87 | $0.87 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.66 Typical High $18.62 | Professional | 55 · Aftercare only | $0.65 | $0.66 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.44 Typical High $12.59 | Professional | 56 · Pre-op care only | $0.43 | $0.44 | $12.59 |
Anthem BCBS Setting Facility Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Anthem BCBS Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $6.03 | Professional | None | $4.27 | $4.27 | $6.03 |
Cigna Setting Facility Modifier None Typical Low $6.61 Median $13.18 Typical High $15.14 | Facility | None | $6.61 | $13.18 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $11.22 | Professional | None | $4.27 | $4.27 | $11.22 |
DeanCare Setting Facility Modifier None Typical Low $7.59 Median $7.76 Typical High $12.59 | Facility | None | $7.59 | $7.76 | $12.59 |
DeanCare Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $15.49 | Professional | None | $7.08 | $7.08 | $15.49 |
Medica Setting Facility Modifier None Typical Low $1.95 Median $1.95 Typical High $12.59 | Facility | None | $1.95 | $1.95 | $12.59 |
Medica Setting Professional Modifier None Typical Low $1.95 Median $2.14 Typical High $25.70 | Professional | None | $1.95 | $2.14 | $25.70 |
Network Health Setting Facility Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Network Health Setting Professional Modifier None Typical Low $6.76 Median $7.59 Typical High $7.76 | Professional | None | $6.76 | $7.59 | $7.76 |
Prevea360 Setting Facility Modifier None Typical Low $7.59 Median $7.76 Typical High $12.59 | Facility | None | $7.59 | $7.76 | $12.59 |
Prevea360 Setting Professional Modifier None Typical Low $11.48 Median $15.49 Typical High $15.49 | Professional | None | $11.48 | $15.49 | $15.49 |
Quartz Setting Professional Modifier None Typical Low $4.27 Median $12.02 Typical High $19.95 | Professional | None | $4.27 | $12.02 | $19.95 |
Quartz Setting Facility Modifier None Typical Low $7.08 Median $13.18 Typical High $13.18 | Facility | None | $7.08 | $13.18 | $13.18 |
Quartz Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Security Health Setting Professional Modifier None Typical Low $5.75 Median $7.08 Typical High $10.23 | Professional | None | $5.75 | $7.08 | $10.23 |
The Alliance Setting Professional Modifier None Typical Low $10.00 Median $19.05 Typical High $26.30 | Professional | None | $10.00 | $19.05 | $26.30 |
United Setting Professional Modifier None Typical Low $5.01 Median $5.50 Typical High $28.84 | Professional | None | $5.01 | $5.50 | $28.84 |
1 more rate 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 $2.14 Median $2.19 Typical High $8.91 | Professional | 52 · Reduced service | $2.14 | $2.19 | $8.91 |
Where Wisconsin sits
The same service costs 5.1 times more in Wyoming than in Alabama. 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· 34th of 51
$4.47
WY $21.88AL $4.27
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.