How much rates vary
Facilitymedian $11 · 10th to 90th $7 to $24Professionalmedian $11 · 10th to 90th $5 to $17
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 $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $22.91 | Professional | None | $10.96 | $10.96 | $22.91 |
Anthem BCBS Setting Facility Modifier None Typical Low $11.22 Median $12.88 Typical High $18.62 | Facility | None | $11.22 | $12.88 | $18.62 |
Anthem BCBS Setting Professional Modifier None Typical Low $6.92 Median $11.22 Typical High $14.45 | Professional | None | $6.92 | $11.22 | $14.45 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $22.39 Typical High $46.77 | Facility | None | $7.08 | $22.39 | $46.77 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $7.94 Typical High $21.38 | Professional | None | $5.25 | $7.94 | $21.38 |
DeanCare Setting Facility Modifier None Typical Low $3.55 Median $10.96 Typical High $12.59 | Facility | None | $3.55 | $10.96 | $12.59 |
DeanCare Setting Professional Modifier None Typical Low $12.02 Median $16.22 Typical High $16.98 | Professional | None | $12.02 | $16.22 | $16.98 |
Medica Setting Facility Modifier None Typical Low $5.62 Median $10.96 Typical High $79.43 | Facility | None | $5.62 | $10.96 | $79.43 |
Medica Setting Professional Modifier None Typical Low $5.13 Median $7.94 Typical High $74.13 | Professional | None | $5.13 | $7.94 | $74.13 |
Network Health Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Facility | None | $17.78 | $17.78 | $17.78 |
Network Health Setting Professional Modifier None Typical Low $7.94 Median $10.47 Typical High $19.50 | Professional | None | $7.94 | $10.47 | $19.50 |
Prevea360 Setting Facility Modifier None Typical Low $3.55 Median $10.96 Typical High $12.59 | Facility | None | $3.55 | $10.96 | $12.59 |
Prevea360 Setting Professional Modifier None Typical Low $6.31 Median $10.96 Typical High $12.88 | Professional | None | $6.31 | $10.96 | $12.88 |
Quartz Setting Professional Modifier None Typical Low $11.22 Median $16.98 Typical High $28.18 | Professional | None | $11.22 | $16.98 | $28.18 |
Quartz Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $7.41 | Facility | None | $7.08 | $7.08 | $7.41 |
Quartz Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.08 | Professional | None | $5.25 | $5.25 | $7.08 |
United Setting Facility Modifier None Typical Low $6.31 Median $7.94 Typical High $18.20 | Facility | None | $6.31 | $7.94 | $18.20 |
United Setting Professional Modifier None Typical Low $4.57 Median $7.41 Typical High $9.77 | Professional | None | $4.57 | $7.41 | $9.77 |
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 $5.50 Median $5.50 Typical High $10.00 | Professional | 52 · Reduced service | $5.50 | $5.50 | $10.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.19 Typical High $3.98 | Professional | 53 · Discontinued | $2.19 | $2.19 | $3.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.66 Typical High $3.02 | Professional | 55 · Aftercare only | $1.66 | $1.66 | $3.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.12 Typical High $2.00 | Professional | 56 · Pre-op care only | $1.12 | $1.12 | $2.00 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.68 Median $0.68 Typical High $0.87 | Professional | RR · Rental | $0.68 | $0.68 | $0.87 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $5.01 Median $5.01 Typical High $6.61 | Professional | UE · Used equipment | $5.01 | $5.01 | $6.61 |
Where Wisconsin sits
The same service costs 3.5 times more in Montana than in Kansas. 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· 12th of 51
$10.96
MT $15.49KS $4.37
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.