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 $3.80 Median $3.80 Typical High $3.80 | Facility | None | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier None Typical Low $2.00 Median $3.80 Typical High $3.89 | Professional | None | $2.00 | $3.80 | $3.89 |
Cigna Setting Facility Modifier None Typical Low $2.34 Median $4.37 Typical High $4.37 | Facility | None | $2.34 | $4.37 | $4.37 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $4.37 Typical High $5.62 | Professional | None | $3.98 | $4.37 | $5.62 |
Hally Health Setting Professional Modifier None Typical Low $3.24 Median $3.89 Typical High $6.76 | Professional | None | $3.24 | $3.89 | $6.76 |
Medica Setting Facility Modifier None Typical Low $2.63 Median $4.27 Typical High $79.43 | Facility | None | $2.63 | $4.27 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.91 Median $3.31 Typical High $8.51 | Professional | None | $1.91 | $3.31 | $8.51 |
Midlands Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.57 | Professional | None | $4.37 | $4.37 | $4.57 |
Midlands Setting Professional Modifier None Typical Low $3.31 Median $6.46 Typical High $6.46 | Professional | None | $3.31 | $6.46 | $6.46 |
United Setting Professional Modifier None Typical Low $1.62 Median $1.95 Typical High $3.39 | Professional | None | $1.62 | $1.95 | $3.39 |
Wellmark Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
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 $1.10 Median $1.91 Typical High $1.95 | Professional | 52 · Reduced service | $1.10 | $1.91 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.76 Typical High $0.78 | Professional | 53 · Discontinued | $0.44 | $0.76 | $0.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.56 Typical High $0.59 | Professional | 55 · Aftercare only | $0.33 | $0.56 | $0.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.38 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.22 | $0.38 | $0.39 |
Where Iowa sits
The same service costs 2.2 times more in Kansas than in Delaware. 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
$3.80
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.