How much rates vary
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 $0.62 Median $0.62 Typical High $0.62 | Facility | None | $0.62 | $0.62 | $0.62 |
Aetna Setting Professional Modifier None Typical Low $0.21 Median $0.62 Typical High $0.62 | Professional | None | $0.21 | $0.62 | $0.62 |
Cigna Setting Professional Modifier None Typical Low $0.68 Median $0.69 Typical High $0.93 | Professional | None | $0.68 | $0.69 | $0.93 |
Hally Health Setting Professional Modifier None Typical Low $0.52 Median $0.69 Typical High $1.23 | Professional | None | $0.52 | $0.69 | $1.23 |
Medica Setting Facility Modifier None Typical Low $0.43 Median $0.71 Typical High $0.85 | Facility | None | $0.43 | $0.71 | $0.85 |
Medica Setting Professional Modifier None Typical Low $0.31 Median $0.52 Typical High $4.27 | Professional | None | $0.31 | $0.52 | $4.27 |
Midlands Setting Professional Modifier None Typical Low $0.69 Median $0.69 Typical High $0.87 | Professional | None | $0.69 | $0.69 | $0.87 |
Midlands Setting Professional Modifier None Typical Low $0.55 Median $1.02 Typical High $1.32 | Professional | None | $0.55 | $1.02 | $1.32 |
United Setting Professional Modifier None Typical Low $0.26 Median $0.31 Typical High $0.54 | Professional | None | $0.26 | $0.31 | $0.54 |
Wellmark Setting Professional Modifier None Typical Low $0.50 Median $0.50 Typical High $0.50 | Professional | None | $0.50 | $0.50 | $0.50 |
5 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 $0.23 Median $0.31 Typical High $0.31 | Professional | 52 · Reduced service | $0.23 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.12 Typical High $0.12 | Professional | 53 · Discontinued | $0.09 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.07 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.05 | $0.06 | $0.06 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.05 Median $0.06 Typical High $0.17 | Professional | RR · Rental | $0.05 | $0.06 | $0.17 |
Where Iowa sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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.
Iowa· 6th of 51
$0.62
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.