How much rates vary
Facilitymedian $8 · 10th to 90th $5 to $18Professionalmedian $8 · 10th to 90th $4 to $13
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 $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $15.14 | Professional | None | $7.94 | $7.94 | $15.14 |
Anthem BCBS Setting Facility Modifier None Typical Low $8.13 Median $9.33 Typical High $13.49 | Facility | None | $8.13 | $9.33 | $13.49 |
Anthem BCBS Setting Professional Modifier None Typical Low $5.01 Median $8.13 Typical High $10.47 | Professional | None | $5.01 | $8.13 | $10.47 |
Cigna Setting Facility Modifier None Typical Low $5.13 Median $16.98 Typical High $34.67 | Facility | None | $5.13 | $16.98 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $3.80 Median $5.75 Typical High $15.49 | Professional | None | $3.80 | $5.75 | $15.49 |
DeanCare Setting Facility Modifier None Typical Low $2.57 Median $7.94 Typical High $9.12 | Facility | None | $2.57 | $7.94 | $9.12 |
DeanCare Setting Professional Modifier None Typical Low $10.72 Median $12.59 Typical High $14.79 | Professional | None | $10.72 | $12.59 | $14.79 |
Medica Setting Facility Modifier None Typical Low $4.07 Median $7.94 Typical High $79.43 | Facility | None | $4.07 | $7.94 | $79.43 |
Medica Setting Professional Modifier None Typical Low $3.72 Median $5.75 Typical High $53.70 | Professional | None | $3.72 | $5.75 | $53.70 |
Network Health Setting Facility Modifier None Typical Low $12.88 Median $12.88 Typical High $12.88 | Facility | None | $12.88 | $12.88 | $12.88 |
Network Health Setting Professional Modifier None Typical Low $5.75 Median $7.59 Typical High $14.13 | Professional | None | $5.75 | $7.59 | $14.13 |
Prevea360 Setting Facility Modifier None Typical Low $2.57 Median $7.94 Typical High $9.12 | Facility | None | $2.57 | $7.94 | $9.12 |
Prevea360 Setting Professional Modifier None Typical Low $4.57 Median $7.94 Typical High $10.72 | Professional | None | $4.57 | $7.94 | $10.72 |
Quartz Setting Professional Modifier None Typical Low $8.13 Median $12.30 Typical High $20.42 | Professional | None | $8.13 | $12.30 | $20.42 |
Quartz Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.37 | Facility | None | $5.13 | $5.13 | $5.37 |
Quartz Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $5.13 | Professional | None | $3.80 | $3.80 | $5.13 |
Security Health Setting Professional Modifier None Typical Low $6.46 Median $7.59 Typical High $7.59 | Professional | None | $6.46 | $7.59 | $7.59 |
United Setting Facility Modifier None Typical Low $4.79 Median $5.37 Typical High $13.18 | Facility | None | $4.79 | $5.37 | $13.18 |
United Setting Professional Modifier None Typical Low $3.31 Median $5.37 Typical High $7.08 | Professional | None | $3.31 | $5.37 | $7.08 |
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 $3.98 Median $3.98 Typical High $7.59 | Professional | 52 · Reduced service | $3.98 | $3.98 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.58 Median $1.58 Typical High $3.02 | Professional | 53 · Discontinued | $1.58 | $1.58 | $3.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.20 Median $1.20 Typical High $2.24 | Professional | 55 · Aftercare only | $1.20 | $1.20 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $0.79 Typical High $1.51 | Professional | 56 · Pre-op care only | $0.79 | $0.79 | $1.51 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.49 Median $0.49 Typical High $0.62 | Professional | RR · Rental | $0.49 | $0.49 | $0.62 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $3.63 Median $3.72 Typical High $5.01 | Professional | UE · Used equipment | $3.63 | $3.72 | $5.01 |
Where Wisconsin sits
The same service costs 3.2 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
$7.94
HI $12.02DE $3.80
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.