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 $0.76 Median $0.76 Typical High $0.76 | Facility | None | $0.76 | $0.76 | $0.76 |
Aetna Setting Professional Modifier None Typical Low $0.56 Median $0.76 Typical High $0.78 | Professional | None | $0.56 | $0.76 | $0.78 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $0.87 Typical High $1.05 | Professional | None | $0.76 | $0.87 | $1.05 |
Hally Health Setting Professional Modifier None Typical Low $0.78 Median $0.85 Typical High $1.10 | Professional | None | $0.78 | $0.85 | $1.10 |
Medica Setting Facility Modifier None Typical Low $0.54 Median $0.89 Typical High $1.00 | Facility | None | $0.54 | $0.89 | $1.00 |
Medica Setting Professional Modifier None Typical Low $0.38 Median $0.68 Typical High $3.89 | Professional | None | $0.38 | $0.68 | $3.89 |
Midlands Setting Professional Modifier None Typical Low $0.87 Median $0.87 Typical High $1.05 | Professional | None | $0.87 | $0.87 | $1.05 |
Midlands Setting Professional Modifier None Typical Low $0.68 Median $1.12 Typical High $1.70 | Professional | None | $0.68 | $1.12 | $1.70 |
United Setting Professional Modifier None Typical Low $0.33 Median $0.39 Typical High $0.68 | Professional | None | $0.33 | $0.39 | $0.68 |
Wellmark Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
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 $0.28 Median $0.38 Typical High $0.39 | Professional | 52 · Reduced service | $0.28 | $0.38 | $0.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.15 Typical High $0.16 | Professional | 53 · Discontinued | $0.12 | $0.15 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.11 Typical High $0.12 | Professional | 55 · Aftercare only | $0.09 | $0.11 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.06 | $0.08 | $0.08 |
Where Iowa sits
The same service costs 2.6 times more in Hawaii than in Utah. 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· 5th of 51
$0.76
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.