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 $0.28 Median $0.28 Typical High $0.28 | Facility | None | $0.28 | $0.28 | $0.28 |
Aetna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.30 | Professional | None | $0.28 | $0.28 | $0.30 |
Cigna Setting Professional Modifier None Typical Low $0.44 Median $0.50 Typical High $4.17 | Professional | None | $0.44 | $0.50 | $4.17 |
Hally Health Setting Professional Modifier None Typical Low $0.55 Median $0.59 Typical High $199.53 | Professional | None | $0.55 | $0.59 | $199.53 |
Medica Setting Facility Modifier None Typical Low $0.37 Median $0.42 Typical High $0.85 | Facility | None | $0.37 | $0.42 | $0.85 |
Medica Setting Professional Modifier None Typical Low $0.20 Median $0.42 Typical High $10.23 | Professional | None | $0.20 | $0.42 | $10.23 |
Midlands Setting Professional Modifier None Typical Low $0.50 Median $0.50 Typical High $0.81 | Professional | None | $0.50 | $0.50 | $0.81 |
Midlands Setting Professional Modifier None Typical Low $0.58 Median $0.68 Typical High $0.91 | Professional | None | $0.58 | $0.68 | $0.91 |
United Setting Professional Modifier None Typical Low $0.19 Median $0.20 Typical High $0.35 | Professional | None | $0.19 | $0.20 | $0.35 |
Wellmark Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $0.60 | Professional | None | $0.60 | $0.60 | $0.60 |
2 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 55 · Aftercare only Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | 55 · Aftercare only | $0.04 | $0.04 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.03 |
Where Iowa sits
The same service costs 15.5 times more in Minnesota than in Hawaii. 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· 3rd of 51
$0.44
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.