How much rates vary
Facilitymedian $9 · 10th to 90th $5 to $16Professionalmedian $5 · 10th to 90th $5 to $9
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 $5.50 Median $5.50 Typical High $11.22 | Facility | None | $5.50 | $5.50 | $11.22 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.50 Typical High $6.61 | Professional | None | $5.25 | $5.50 | $6.61 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.81 Typical High $46.77 | Professional | 55 · Aftercare only | $0.79 | $0.81 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.54 Typical High $30.90 | Professional | 56 · Pre-op care only | $0.52 | $0.54 | $30.90 |
Anthem BCBS Setting Facility Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Facility | None | $6.61 | $6.61 | $6.61 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.41 | Professional | None | $5.25 | $5.25 | $7.41 |
CareSource Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $10.47 | Professional | None | $6.76 | $6.76 | $10.47 |
Cigna Setting Facility Modifier None Typical Low $8.13 Median $14.13 Typical High $16.22 | Facility | None | $8.13 | $14.13 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $10.23 | Professional | None | $5.25 | $5.25 | $10.23 |
DeanCare Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
DeanCare Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $13.49 | Professional | None | $7.24 | $7.24 | $13.49 |
Medica Setting Facility Modifier None Typical Low $6.92 Median $6.92 Typical High $33.88 | Facility | None | $6.92 | $6.92 | $33.88 |
Medica Setting Professional Modifier None Typical Low $6.92 Median $7.76 Typical High $9.77 | Professional | None | $6.92 | $7.76 | $9.77 |
Network Health Setting Facility Modifier None Typical Low $8.91 Median $8.91 Typical High $13.49 | Facility | None | $8.91 | $8.91 | $13.49 |
Network Health Setting Professional Modifier None Typical Low $6.92 Median $7.94 Typical High $7.94 | Professional | None | $6.92 | $7.94 | $7.94 |
Prevea360 Setting Facility Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | None | $6.76 | $6.76 | $6.76 |
Prevea360 Setting Professional Modifier None Typical Low $10.00 Median $13.49 Typical High $13.49 | Professional | None | $10.00 | $13.49 | $13.49 |
Quartz Setting Professional Modifier None Typical Low $5.25 Median $10.00 Typical High $16.98 | Professional | None | $5.25 | $10.00 | $16.98 |
Quartz Setting Facility Modifier None Typical Low $8.71 Median $16.22 Typical High $16.22 | Facility | None | $8.71 | $16.22 | $16.22 |
Quartz Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Security Health Setting Professional Modifier None Typical Low $7.08 Median $7.08 Typical High $8.71 | Professional | None | $7.08 | $7.08 | $8.71 |
The Alliance Setting Professional Modifier None Typical Low $7.94 Median $16.60 Typical High $40.74 | Professional | None | $7.94 | $16.60 | $40.74 |
United Setting Professional Modifier None Typical Low $4.90 Median $5.25 Typical High $6.31 | Professional | None | $4.90 | $5.25 | $6.31 |
2 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 $2.63 Median $2.69 Typical High $2.69 | Professional | 52 · Reduced service | $2.63 | $2.69 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.10 Typical High $4.17 | Professional | 53 · Discontinued | $1.07 | $1.10 | $4.17 |
Where Wisconsin sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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
$5.50
WY $10.00CO $5.25
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.