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 $3.31 Median $3.31 Typical High $7.59 | Facility | None | $3.31 | $3.31 | $7.59 |
Aetna Setting Professional Modifier None Typical Low $2.51 Median $3.31 Typical High $3.39 | Professional | None | $2.51 | $3.31 | $3.39 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.98 Typical High $4.79 | Professional | None | $3.72 | $3.98 | $4.79 |
Hally Health Setting Professional Modifier None Typical Low $3.39 Median $5.25 Typical High $151.36 | Professional | None | $3.39 | $5.25 | $151.36 |
Medica Setting Facility Modifier None Typical Low $3.89 Median $4.17 Typical High $4.79 | Facility | None | $3.89 | $4.17 | $4.79 |
Medica Setting Professional Modifier None Typical Low $1.70 Median $3.31 Typical High $16.98 | Professional | None | $1.70 | $3.31 | $16.98 |
Midlands Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $4.90 | Professional | None | $3.98 | $3.98 | $4.90 |
Midlands Setting Professional Modifier None Typical Low $4.07 Median $5.50 Typical High $10.23 | Professional | None | $4.07 | $5.50 | $10.23 |
United Setting Professional Modifier None Typical Low $1.55 Median $1.70 Typical High $2.95 | Professional | None | $1.55 | $1.70 | $2.95 |
Wellmark Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
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 $1.26 Median $1.66 Typical High $1.70 | Professional | 52 · Reduced service | $1.26 | $1.66 | $1.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.66 Typical High $0.68 | Professional | 53 · Discontinued | $0.50 | $0.66 | $0.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.38 Median $0.50 Typical High $0.51 | Professional | 55 · Aftercare only | $0.38 | $0.50 | $0.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.33 Typical High $0.34 | Professional | 56 · Pre-op care only | $0.25 | $0.33 | $0.34 |
Where Iowa sits
The same service costs 2.3 times more in Hawaii than in Kentucky. 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· 7th of 51
$3.31
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.