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 $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $5.13 Typical High $5.25 | Professional | None | $2.95 | $5.13 | $5.25 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $5.89 Typical High $5.89 | Facility | None | $3.55 | $5.89 | $5.89 |
Cigna Setting Professional Modifier None Typical Low $5.37 Median $5.89 Typical High $7.59 | Professional | None | $5.37 | $5.89 | $7.59 |
Hally Health Setting Professional Modifier None Typical Low $5.25 Median $6.03 Typical High $7.08 | Professional | None | $5.25 | $6.03 | $7.08 |
Medica Setting Facility Modifier None Typical Low $3.55 Median $5.75 Typical High $79.43 | Facility | None | $3.55 | $5.75 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.57 Median $4.47 Typical High $11.48 | Professional | None | $2.57 | $4.47 | $11.48 |
Midlands Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $6.17 | Professional | None | $5.89 | $5.89 | $6.17 |
Midlands Setting Professional Modifier None Typical Low $4.47 Median $8.71 Typical High $8.71 | Professional | None | $4.47 | $8.71 | $8.71 |
United Setting Professional Modifier None Typical Low $2.19 Median $2.63 Typical High $4.68 | Professional | None | $2.19 | $2.63 | $4.68 |
Wellmark Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
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 $1.48 Median $2.57 Typical High $2.63 | Professional | 52 · Reduced service | $1.48 | $2.57 | $2.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $1.02 Typical High $1.05 | Professional | 53 · Discontinued | $0.59 | $1.02 | $1.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.78 Typical High $0.79 | Professional | 55 · Aftercare only | $0.44 | $0.78 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.52 Typical High $0.52 | Professional | 56 · Pre-op care only | $0.30 | $0.52 | $0.52 |
Where Iowa sits
The same service costs 2.6 times more in Kansas than in New Hampshire. 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
$5.13
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.