How much rates vary
Facilitymedian $19 · 10th to 90th $14 to $42Professionalmedian $19 · 10th to 90th $10 to $31
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 $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $34.67 | Professional | None | $19.05 | $19.05 | $34.67 |
Anthem BCBS Setting Facility Modifier None Typical Low $19.05 Median $21.88 Typical High $31.62 | Facility | None | $19.05 | $21.88 | $31.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $14.13 Median $19.05 Typical High $26.30 | Professional | None | $14.13 | $19.05 | $26.30 |
Cigna Setting Facility Modifier None Typical Low $14.45 Median $39.81 Typical High $79.43 | Facility | None | $14.45 | $39.81 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $15.85 Typical High $36.31 | Professional | None | $10.47 | $15.85 | $36.31 |
DeanCare Setting Facility Modifier None Typical Low $6.03 Median $19.05 Typical High $21.88 | Facility | None | $6.03 | $19.05 | $21.88 |
DeanCare Setting Professional Modifier None Typical Low $20.89 Median $31.62 Typical High $33.11 | Professional | None | $20.89 | $31.62 | $33.11 |
Medica Setting Facility Modifier None Typical Low $9.55 Median $19.05 Typical High $102.33 | Facility | None | $9.55 | $19.05 | $102.33 |
Medica Setting Professional Modifier None Typical Low $8.71 Median $13.80 Typical High $125.89 | Professional | None | $8.71 | $13.80 | $125.89 |
Network Health Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Network Health Setting Professional Modifier None Typical Low $13.80 Median $17.78 Typical High $33.11 | Professional | None | $13.80 | $17.78 | $33.11 |
Prevea360 Setting Facility Modifier None Typical Low $6.03 Median $19.05 Typical High $21.88 | Facility | None | $6.03 | $19.05 | $21.88 |
Prevea360 Setting Professional Modifier None Typical Low $10.72 Median $19.05 Typical High $25.12 | Professional | None | $10.72 | $19.05 | $25.12 |
Quartz Setting Professional Modifier None Typical Low $19.05 Median $28.84 Typical High $47.86 | Professional | None | $19.05 | $28.84 | $47.86 |
Quartz Setting Facility Modifier None Typical Low $14.45 Median $14.45 Typical High $14.45 | Facility | None | $14.45 | $14.45 | $14.45 |
Quartz Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $14.45 | Professional | None | $10.47 | $10.47 | $14.45 |
Security Health Setting Professional Modifier None Typical Low $15.14 Median $17.78 Typical High $17.78 | Professional | None | $15.14 | $17.78 | $17.78 |
United Setting Facility Modifier None Typical Low $12.59 Median $12.88 Typical High $30.90 | Facility | None | $12.59 | $12.88 | $30.90 |
United Setting Professional Modifier None Typical Low $7.94 Median $12.59 Typical High $16.60 | Professional | None | $7.94 | $12.59 | $16.60 |
6 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 $9.33 Median $9.33 Typical High $15.85 | Professional | 52 · Reduced service | $9.33 | $9.33 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.80 Median $3.80 Typical High $6.46 | Professional | 53 · Discontinued | $3.80 | $3.80 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $2.82 Typical High $4.79 | Professional | 55 · Aftercare only | $2.82 | $2.82 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.91 Median $1.91 Typical High $3.24 | Professional | 56 · Pre-op care only | $1.91 | $1.91 | $3.24 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.35 Median $1.35 Typical High $1.51 | Professional | RR · Rental | $1.35 | $1.35 | $1.51 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $10.23 Median $10.96 Typical High $14.13 | Professional | UE · Used equipment | $10.23 | $10.96 | $14.13 |
Where Wisconsin sits
The same service costs 3.0 times more in Hawaii than in Delaware. 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· 9th of 51
$19.05
HI $31.62DE $10.47
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.