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 $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $4.27 Typical High $4.27 | Professional | None | $1.58 | $4.27 | $4.27 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $5.25 Typical High $6.61 | Professional | None | $4.47 | $5.25 | $6.61 |
Cigna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $4.90 Median $4.90 Typical High $6.17 | Professional | AU · Urologic/ostomy supply | $4.90 | $4.90 | $6.17 |
Hally Health Setting Professional Modifier None Typical Low $3.72 Median $4.68 Typical High $6.76 | Professional | None | $3.72 | $4.68 | $6.76 |
Medica Setting Facility Modifier None Typical Low $3.02 Median $5.01 Typical High $6.03 | Facility | None | $3.02 | $5.01 | $6.03 |
Medica Setting Professional Modifier None Typical Low $2.14 Median $3.72 Typical High $21.88 | Professional | None | $2.14 | $3.72 | $21.88 |
Midlands Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
Midlands Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $4.90 Median $4.90 Typical High $6.17 | Professional | AU · Urologic/ostomy supply | $4.90 | $4.90 | $6.17 |
Midlands Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | None | $5.13 | $5.13 | $5.13 |
United Setting Professional Modifier None Typical Low $1.86 Median $2.19 Typical High $3.89 | Professional | None | $1.86 | $2.19 | $3.89 |
Wellmark Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
4 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 $1.62 Median $2.14 Typical High $2.14 | Professional | 52 · Reduced service | $1.62 | $2.14 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.85 Typical High $0.85 | Professional | 53 · Discontinued | $0.65 | $0.85 | $0.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.65 Typical High $0.65 | Professional | 55 · Aftercare only | $0.49 | $0.65 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.43 Typical High $0.43 | Professional | 56 · Pre-op care only | $0.32 | $0.43 | $0.43 |
Where Iowa sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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· 8th of 51
$3.63
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.