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 $2.51 Median $2.51 Typical High $2.51 | Facility | None | $2.51 | $2.51 | $2.51 |
Aetna Setting Professional Modifier None Typical Low $1.45 Median $2.51 Typical High $2.57 | Professional | None | $1.45 | $2.51 | $2.57 |
Cigna Setting Facility Modifier None Typical Low $1.55 Median $2.88 Typical High $2.88 | Facility | None | $1.55 | $2.88 | $2.88 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $2.88 Typical High $3.72 | Professional | None | $2.69 | $2.88 | $3.72 |
Hally Health Setting Professional Modifier None Typical Low $2.57 Median $2.95 Typical High $3.63 | Professional | None | $2.57 | $2.95 | $3.63 |
Medica Setting Facility Modifier None Typical Low $1.78 Median $2.82 Typical High $79.43 | Facility | None | $1.78 | $2.82 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.26 Median $2.24 Typical High $5.62 | Professional | None | $1.26 | $2.24 | $5.62 |
Midlands Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $3.02 | Professional | None | $2.88 | $2.88 | $3.02 |
Midlands Setting Professional Modifier None Typical Low $2.24 Median $4.37 Typical High $4.37 | Professional | None | $2.24 | $4.37 | $4.37 |
United Setting Professional Modifier None Typical Low $1.07 Median $1.29 Typical High $2.29 | Professional | None | $1.07 | $1.29 | $2.29 |
Wellmark Setting Professional Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Professional | None | $2.09 | $2.09 | $2.09 |
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 $0.72 Median $1.26 Typical High $1.29 | Professional | 52 · Reduced service | $0.72 | $1.26 | $1.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.28 Median $0.51 Typical High $0.52 | Professional | 53 · Discontinued | $0.28 | $0.51 | $0.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.38 Typical High $0.39 | Professional | 55 · Aftercare only | $0.22 | $0.38 | $0.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.25 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.15 | $0.25 | $0.26 |
Where Iowa sits
The same service costs 2.3 times more in Kansas than in New Jersey. 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· 5th of 51
$2.51
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.