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 $0.58 Median $0.58 Typical High $0.58 | Facility | None | $0.58 | $0.58 | $0.58 |
Aetna Setting Professional Modifier None Typical Low $0.58 Median $0.58 Typical High $0.59 | Professional | None | $0.58 | $0.58 | $0.59 |
Cigna Setting Professional Modifier None Typical Low $0.87 Median $1.00 Typical High $3.16 | Professional | None | $0.87 | $1.00 | $3.16 |
Hally Health Setting Professional Modifier None Typical Low $2.24 Median $2.34 Typical High $199.53 | Professional | None | $2.24 | $2.34 | $199.53 |
Medica Setting Facility Modifier None Typical Low $0.74 Median $0.83 Typical High $7.76 | Facility | None | $0.74 | $0.83 | $7.76 |
Medica Setting Professional Modifier None Typical Low $0.39 Median $0.83 Typical High $7.08 | Professional | None | $0.39 | $0.83 | $7.08 |
Midlands Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $3.63 | Professional | None | $1.00 | $1.00 | $3.63 |
Midlands Setting Professional Modifier None Typical Low $1.12 Median $1.35 Typical High $3.63 | Professional | None | $1.12 | $1.35 | $3.63 |
United Setting Professional Modifier None Typical Low $0.38 Median $0.39 Typical High $0.69 | Professional | None | $0.38 | $0.39 | $0.69 |
Wellmark Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $2.34 | Professional | None | $2.34 | $2.34 | $2.34 |
2 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 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Where Iowa sits
The same service costs 190.5 times more in Wyoming 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· 19th of 51
$0.87
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.