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 $2.57 Median $2.57 Typical High $2.57 | Facility | None | $2.57 | $2.57 | $2.57 |
Aetna Setting Professional Modifier None Typical Low $1.95 Median $2.57 Typical High $2.63 | Professional | None | $1.95 | $2.57 | $2.63 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $2.95 Typical High $3.72 | Professional | None | $2.88 | $2.95 | $3.72 |
Hally Health Setting Professional Modifier None Typical Low $2.63 Median $2.88 Typical High $3.63 | Professional | None | $2.63 | $2.88 | $3.63 |
Medica Setting Facility Modifier None Typical Low $1.78 Median $2.95 Typical High $3.39 | Facility | None | $1.78 | $2.95 | $3.39 |
Medica Setting Professional Modifier None Typical Low $1.29 Median $2.24 Typical High $12.88 | Professional | None | $1.29 | $2.24 | $12.88 |
Midlands Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.47 | Professional | None | $2.95 | $2.95 | $3.47 |
Midlands Setting Professional Modifier None Typical Low $2.29 Median $3.80 Typical High $5.75 | Professional | None | $2.29 | $3.80 | $5.75 |
United Setting Professional Modifier None Typical Low $1.12 Median $1.32 Typical High $2.29 | Professional | None | $1.12 | $1.32 | $2.29 |
Wellmark Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
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 $0.98 Median $1.29 Typical High $1.32 | Professional | 52 · Reduced service | $0.98 | $1.29 | $1.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.39 Median $0.51 Typical High $0.52 | Professional | 53 · Discontinued | $0.39 | $0.51 | $0.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.38 Typical High $0.39 | Professional | 55 · Aftercare only | $0.28 | $0.38 | $0.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.26 Typical High $0.26 | Professional | 56 · Pre-op care only | $0.19 | $0.26 | $0.26 |
Where Iowa sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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
$2.57
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.