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 $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $8.13 Typical High $9.55 | Professional | None | $4.17 | $8.13 | $9.55 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $9.33 Typical High $9.33 | Facility | None | $5.75 | $9.33 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $10.96 Typical High $13.80 | Professional | None | $8.71 | $10.96 | $13.80 |
Hally Health Setting Professional Modifier None Typical Low $8.32 Median $9.33 Typical High $14.45 | Professional | None | $8.32 | $9.33 | $14.45 |
Medica Setting Facility Modifier None Typical Low $5.62 Median $9.12 Typical High $79.43 | Facility | None | $5.62 | $9.12 | $79.43 |
Medica Setting Professional Modifier None Typical Low $4.07 Median $8.13 Typical High $20.89 | Professional | None | $4.07 | $8.13 | $20.89 |
Midlands Setting Professional Modifier None Typical Low $9.55 Median $10.96 Typical High $10.96 | Professional | None | $9.55 | $10.96 | $10.96 |
Midlands Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Midlands Setting Professional Modifier None Typical Low $8.32 Median $13.80 Typical High $13.80 | Professional | None | $8.32 | $13.80 | $13.80 |
United Setting Professional Modifier None Typical Low $3.98 Median $4.07 Typical High $7.59 | Professional | None | $3.98 | $4.07 | $7.59 |
Wellmark Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
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 $2.51 Median $4.07 Typical High $4.79 | Professional | 52 · Reduced service | $2.51 | $4.07 | $4.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $1.62 Typical High $1.91 | Professional | 53 · Discontinued | $1.02 | $1.62 | $1.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.76 Median $1.20 Typical High $1.41 | Professional | 55 · Aftercare only | $0.76 | $1.20 | $1.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.81 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.51 | $0.81 | $0.95 |
Where Iowa sits
The same service costs 2.5 times more in Montana 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· 9th of 51
$8.13
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.