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 $0.15 Median $0.15 Typical High $0.15 | Facility | None | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier None Typical Low $0.09 Median $0.15 Typical High $0.15 | Professional | None | $0.09 | $0.15 | $0.15 |
Cigna Setting Facility Modifier None Typical Low $0.09 Median $0.17 Typical High $0.17 | Facility | None | $0.09 | $0.17 | $0.17 |
Cigna Setting Professional Modifier None Typical Low $0.16 Median $0.17 Typical High $0.40 | Professional | None | $0.16 | $0.17 | $0.40 |
Hally Health Setting Professional Modifier None Typical Low $0.15 Median $0.18 Typical High $0.31 | Professional | None | $0.15 | $0.18 | $0.31 |
Medica Setting Facility Modifier None Typical Low $0.11 Median $0.17 Typical High $79.43 | Facility | None | $0.11 | $0.17 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.08 Median $0.14 Typical High $0.34 | Professional | None | $0.08 | $0.14 | $0.34 |
Midlands Setting Professional Modifier None Typical Low $0.17 Median $0.17 Typical High $0.19 | Professional | None | $0.17 | $0.17 | $0.19 |
Midlands Setting Professional Modifier None Typical Low $0.14 Median $0.27 Typical High $0.27 | Professional | None | $0.14 | $0.27 | $0.27 |
United Setting Professional Modifier None Typical Low $0.07 Median $0.08 Typical High $0.14 | Professional | None | $0.07 | $0.08 | $0.14 |
Wellmark Setting Professional Modifier None Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | None | $0.12 | $0.12 | $0.12 |
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 $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where Iowa sits
The same service costs 2.0 times more in Idaho than in Ohio. 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
$0.15
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.