How much rates vary
Facilitymedian $1 · 10th to 90th $0 to $2Professionalmedian $1 · 10th to 90th $0 to $1
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 $0.76 Median $0.76 Typical High $0.76 | Facility | None | $0.76 | $0.76 | $0.76 |
Aetna Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $2.00 | Professional | None | $0.76 | $0.76 | $2.00 |
Anthem BCBS Setting Facility Modifier None Typical Low $0.78 Median $0.87 Typical High $1.26 | Facility | None | $0.78 | $0.87 | $1.26 |
Anthem BCBS Setting Professional Modifier None Typical Low $0.59 Median $0.78 Typical High $0.93 | Professional | None | $0.59 | $0.78 | $0.93 |
Cigna Setting Facility Modifier None Typical Low $0.42 Median $1.86 Typical High $2.75 | Facility | None | $0.42 | $1.86 | $2.75 |
Cigna Setting Professional Modifier None Typical Low $0.36 Median $0.45 Typical High $1.45 | Professional | None | $0.36 | $0.45 | $1.45 |
DeanCare Setting Facility Modifier None Typical Low $0.22 Median $0.76 Typical High $0.85 | Facility | None | $0.22 | $0.76 | $0.85 |
DeanCare Setting Professional Modifier None Typical Low $0.76 Median $0.87 Typical High $0.95 | Professional | None | $0.76 | $0.87 | $0.95 |
Medica Setting Facility Modifier None Typical Low $0.38 Median $0.76 Typical High $79.43 | Facility | None | $0.38 | $0.76 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.34 Median $0.50 Typical High $3.80 | Professional | None | $0.34 | $0.50 | $3.80 |
Network Health Setting Professional Modifier None Typical Low $0.54 Median $0.71 Typical High $1.32 | Professional | None | $0.54 | $0.71 | $1.32 |
Prevea360 Setting Facility Modifier None Typical Low $0.22 Median $0.76 Typical High $0.85 | Facility | None | $0.22 | $0.76 | $0.85 |
Prevea360 Setting Professional Modifier None Typical Low $0.42 Median $0.74 Typical High $0.76 | Professional | None | $0.42 | $0.74 | $0.76 |
Quartz Setting Professional Modifier None Typical Low $0.78 Median $1.15 Typical High $1.82 | Professional | None | $0.78 | $1.15 | $1.82 |
Quartz Setting Facility Modifier None Typical Low $0.42 Median $0.42 Typical High $0.42 | Facility | None | $0.42 | $0.42 | $0.42 |
Quartz Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.42 | Professional | None | $0.36 | $0.36 | $0.42 |
United Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
United Setting Professional Modifier None Typical Low $0.28 Median $0.48 Typical High $0.65 | Professional | None | $0.28 | $0.48 | $0.65 |
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 $0.38 Median $0.38 Typical High $1.00 | Professional | 52 · Reduced service | $0.38 | $0.38 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.15 Typical High $0.40 | Professional | 53 · Discontinued | $0.15 | $0.15 | $0.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $0.30 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.20 |
Anthem BCBS Setting Professional Modifier RR · Rental Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | RR · Rental | $0.06 | $0.06 | $0.06 |
Anthem BCBS Setting Professional Modifier UE · Used equipment Typical Low $0.44 Median $0.59 Typical High $0.62 | Professional | UE · Used equipment | $0.44 | $0.59 | $0.62 |
Where Wisconsin sits
The same service costs 2.3 times more in Montana than in Hawaii. 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· 5th of 51
$0.76
MT $0.81HI $0.35
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.