How much rates vary
Facilitymedian $26 · 10th to 90th $16 to $55Professionalmedian $25 · 10th to 90th $12 to $40
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 $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $43.65 | Professional | None | $25.12 | $25.12 | $43.65 |
Anthem BCBS Setting Facility Modifier None Typical Low $25.70 Median $29.51 Typical High $42.66 | Facility | None | $25.70 | $29.51 | $42.66 |
Anthem BCBS Setting Professional Modifier None Typical Low $18.62 Median $25.70 Typical High $32.36 | Professional | None | $18.62 | $25.70 | $32.36 |
Cigna Setting Facility Modifier None Typical Low $16.22 Median $51.29 Typical High $107.15 | Facility | None | $16.22 | $51.29 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $18.20 Typical High $48.98 | Professional | None | $12.02 | $18.20 | $48.98 |
DeanCare Setting Facility Modifier None Typical Low $7.59 Median $25.12 Typical High $28.84 | Facility | None | $7.59 | $25.12 | $28.84 |
DeanCare Setting Professional Modifier None Typical Low $27.54 Median $37.15 Typical High $39.81 | Professional | None | $27.54 | $37.15 | $39.81 |
Medica Setting Facility Modifier None Typical Low $12.59 Median $25.12 Typical High $125.89 | Facility | None | $12.59 | $25.12 | $125.89 |
Medica Setting Professional Modifier None Typical Low $11.75 Median $17.38 Typical High $147.91 | Professional | None | $11.75 | $17.38 | $147.91 |
Network Health Setting Professional Modifier None Typical Low $18.20 Median $23.44 Typical High $43.65 | Professional | None | $18.20 | $23.44 | $43.65 |
Prevea360 Setting Facility Modifier None Typical Low $7.59 Median $25.12 Typical High $28.84 | Facility | None | $7.59 | $25.12 | $28.84 |
Prevea360 Setting Professional Modifier None Typical Low $14.45 Median $25.12 Typical High $30.90 | Professional | None | $14.45 | $25.12 | $30.90 |
Quartz Setting Professional Modifier None Typical Low $25.70 Median $37.15 Typical High $58.88 | Professional | None | $25.70 | $37.15 | $58.88 |
Quartz Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.98 | Facility | None | $16.22 | $16.22 | $16.98 |
Quartz Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.22 | Professional | None | $12.02 | $12.02 | $16.22 |
Security Health Setting Professional Modifier None Typical Low $19.95 Median $23.44 Typical High $23.44 | Professional | None | $19.95 | $23.44 | $23.44 |
The Alliance Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
United Setting Facility Modifier None Typical Low $12.88 Median $15.49 Typical High $38.02 | Facility | None | $12.88 | $15.49 | $38.02 |
United Setting Professional Modifier None Typical Low $9.77 Median $16.60 Typical High $21.38 | Professional | None | $9.77 | $16.60 | $21.38 |
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 $12.59 Median $12.59 Typical High $20.89 | Professional | 52 · Reduced service | $12.59 | $12.59 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $8.32 | Professional | 53 · Discontinued | $5.01 | $5.01 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $3.80 Typical High $6.31 | Professional | 55 · Aftercare only | $3.80 | $3.80 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $2.51 Typical High $4.17 | Professional | 56 · Pre-op care only | $2.51 | $2.51 | $4.17 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $1.82 Median $1.82 Typical High $1.95 | Professional | RR · Rental | $1.82 | $1.82 | $1.95 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $13.49 Median $13.49 Typical High $14.13 | Professional | UE · Used equipment | $13.49 | $13.49 | $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· 6th of 51
$25.12
HI $35.48DE $12.02
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.