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 $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
Aetna Setting Professional Modifier None Typical Low $2.19 Median $3.80 Typical High $4.37 | Professional | None | $2.19 | $3.80 | $4.37 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $5.01 Typical High $5.01 | Facility | None | $2.69 | $5.01 | $5.01 |
Cigna Setting Professional Modifier None Typical Low $4.17 Median $5.01 Typical High $6.03 | Professional | None | $4.17 | $5.01 | $6.03 |
Hally Health Setting Professional Modifier None Typical Low $3.80 Median $5.37 Typical High $7.41 | Professional | None | $3.80 | $5.37 | $7.41 |
Medica Setting Facility Modifier None Typical Low $3.02 Median $4.90 Typical High $79.43 | Facility | None | $3.02 | $4.90 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.19 Median $3.80 Typical High $9.77 | Professional | None | $2.19 | $3.80 | $9.77 |
Midlands Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.25 | Professional | None | $5.01 | $5.01 | $5.25 |
Midlands Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
Midlands Setting Professional Modifier None Typical Low $3.80 Median $7.41 Typical High $7.41 | Professional | None | $3.80 | $7.41 | $7.41 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.24 Typical High $4.07 | Professional | None | $1.91 | $2.24 | $4.07 |
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 $1.10 Median $1.95 Typical High $2.19 | Professional | 52 · Reduced service | $1.10 | $1.95 | $2.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.44 Median $0.78 Typical High $0.87 | Professional | 53 · Discontinued | $0.44 | $0.78 | $0.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.33 Median $0.58 Typical High $0.65 | Professional | 55 · Aftercare only | $0.33 | $0.58 | $0.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.22 Median $0.39 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.22 | $0.39 | $0.44 |
Where Iowa sits
The same service costs 2.1 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· 2nd of 51
$4.27
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.