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 $8.91 Median $8.91 Typical High $8.91 | Facility | None | $8.91 | $8.91 | $8.91 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $8.91 Typical High $9.12 | Professional | None | $5.13 | $8.91 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $10.23 Typical High $10.23 | Facility | None | $5.50 | $10.23 | $10.23 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $10.23 Typical High $13.18 | Professional | None | $9.33 | $10.23 | $13.18 |
Hally Health Setting Professional Modifier None Typical Low $9.12 Median $10.00 Typical High $15.49 | Professional | None | $9.12 | $10.00 | $15.49 |
Medica Setting Facility Modifier None Typical Low $6.17 Median $10.00 Typical High $79.43 | Facility | None | $6.17 | $10.00 | $79.43 |
Medica Setting Professional Modifier None Typical Low $4.47 Median $7.76 Typical High $19.95 | Professional | None | $4.47 | $7.76 | $19.95 |
Midlands Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $10.72 | Professional | None | $10.23 | $10.23 | $10.72 |
Midlands Setting Professional Modifier None Typical Low $7.76 Median $15.14 Typical High $15.14 | Professional | None | $7.76 | $15.14 | $15.14 |
United Setting Professional Modifier None Typical Low $3.80 Median $4.57 Typical High $7.94 | Professional | None | $3.80 | $4.57 | $7.94 |
Wellmark Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.41 | Professional | None | $7.41 | $7.41 | $7.41 |
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 $2.57 Median $4.47 Typical High $4.57 | Professional | 52 · Reduced service | $2.57 | $4.47 | $4.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $1.78 Typical High $1.82 | Professional | 53 · Discontinued | $1.02 | $1.78 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $1.35 Typical High $1.38 | Professional | 55 · Aftercare only | $0.78 | $1.35 | $1.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.89 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.51 | $0.89 | $0.91 |
Where Iowa sits
The same service costs 2.3 times more in Kansas than in Alabama. 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
$8.91
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.