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 $0.12 Median $0.12 Typical High $0.12 | Facility | None | $0.12 | $0.12 | $0.12 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $0.06 Median $0.06 Typical High $0.06 | Facility | 52 · Reduced service | $0.06 | $0.06 | $0.06 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.02 | Facility | 53 · Discontinued | $0.02 | $0.02 | $0.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Facility | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier None Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | None | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 52 · Reduced service | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Cigna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
Medica Setting Facility Modifier None Typical Low $0.12 Median $0.20 Typical High $0.20 | Facility | None | $0.12 | $0.20 | $0.20 |
Medica Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
1 more rate 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 56 · Pre-op care only Typical Low $0.02 Median $1.29 Typical High $1.51 | Professional | 56 · Pre-op care only | $0.02 | $1.29 | $1.51 |
Where Minnesota sits
The same service costs 660.7 times more in Montana than in Louisiana. 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.
Minnesota· 41st of 51
$0.12
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.