How much rates vary
Facilitymedian $29 · 10th to 90th $19 to $63Professionalmedian $29 · 10th to 90th $13 to $45
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 $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $57.54 | Professional | None | $28.84 | $28.84 | $57.54 |
Anthem BCBS Setting Facility Modifier None Typical Low $28.84 Median $33.11 Typical High $47.86 | Facility | None | $28.84 | $33.11 | $47.86 |
Anthem BCBS Setting Professional Modifier None Typical Low $20.42 Median $28.84 Typical High $38.90 | Professional | None | $20.42 | $28.84 | $38.90 |
Cigna Setting Facility Modifier None Typical Low $18.62 Median $58.88 Typical High $123.03 | Facility | None | $18.62 | $58.88 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $20.42 Typical High $54.95 | Professional | None | $13.49 | $20.42 | $54.95 |
DeanCare Setting Facility Modifier None Typical Low $8.51 Median $28.84 Typical High $33.11 | Facility | None | $8.51 | $28.84 | $33.11 |
DeanCare Setting Professional Modifier None Typical Low $30.90 Median $41.69 Typical High $43.65 | Professional | None | $30.90 | $41.69 | $43.65 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $28.84 Typical High $141.25 | Facility | None | $14.45 | $28.84 | $141.25 |
Medica Setting Professional Modifier None Typical Low $13.18 Median $19.95 Typical High $162.18 | Professional | None | $13.18 | $19.95 | $162.18 |
Network Health Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Network Health Setting Professional Modifier None Typical Low $20.42 Median $26.92 Typical High $50.12 | Professional | None | $20.42 | $26.92 | $50.12 |
Prevea360 Setting Facility Modifier None Typical Low $8.51 Median $28.84 Typical High $33.11 | Facility | None | $8.51 | $28.84 | $33.11 |
Prevea360 Setting Professional Modifier None Typical Low $16.22 Median $28.84 Typical High $33.11 | Professional | None | $16.22 | $28.84 | $33.11 |
Quartz Setting Professional Modifier None Typical Low $28.84 Median $42.66 Typical High $67.61 | Professional | None | $28.84 | $42.66 | $67.61 |
Quartz Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $19.05 | Facility | None | $18.62 | $18.62 | $19.05 |
Quartz Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $18.62 | Professional | None | $13.49 | $13.49 | $18.62 |
Security Health Setting Professional Modifier None Typical Low $22.91 Median $26.92 Typical High $26.92 | Professional | None | $22.91 | $26.92 | $26.92 |
United Setting Facility Modifier None Typical Low $14.45 Median $16.60 Typical High $43.65 | Facility | None | $14.45 | $16.60 | $43.65 |
United Setting Professional Modifier None Typical Low $10.96 Median $19.05 Typical High $24.55 | Professional | None | $10.96 | $19.05 | $24.55 |
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 $14.13 Median $14.13 Typical High $22.91 | Professional | 52 · Reduced service | $14.13 | $14.13 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $9.12 | Professional | 53 · Discontinued | $5.75 | $5.75 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $6.92 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $4.57 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $2.00 Median $2.00 Typical High $2.14 | Professional | RR · Rental | $2.00 | $2.00 | $2.14 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $14.79 Median $14.79 Typical High $15.85 | Professional | UE · Used equipment | $14.79 | $14.79 | $15.85 |
Where Wisconsin sits
The same service costs 2.8 times more in Hawaii 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· 8th of 51
$28.84
HI $37.15PA $13.49
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.