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 $0.43 Median $0.43 Typical High $0.43 | Facility | None | $0.43 | $0.43 | $0.43 |
Aetna Setting Professional Modifier None Typical Low $0.32 Median $0.43 Typical High $0.44 | Professional | None | $0.32 | $0.43 | $0.44 |
Cigna Setting Professional Modifier None Typical Low $0.38 Median $0.50 Typical High $0.59 | Professional | None | $0.38 | $0.50 | $0.59 |
Hally Health Setting Professional Modifier None Typical Low $0.44 Median $0.49 Typical High $1.00 | Professional | None | $0.44 | $0.49 | $1.00 |
Medica Setting Facility Modifier None Typical Low $0.31 Median $0.50 Typical High $0.68 | Facility | None | $0.31 | $0.50 | $0.68 |
Medica Setting Professional Modifier None Typical Low $0.22 Median $0.38 Typical High $2.19 | Professional | None | $0.22 | $0.38 | $2.19 |
Midlands Setting Professional Modifier None Typical Low $0.50 Median $0.50 Typical High $0.59 | Professional | None | $0.50 | $0.50 | $0.59 |
Midlands Setting Professional Modifier None Typical Low $0.39 Median $0.65 Typical High $0.98 | Professional | None | $0.39 | $0.65 | $0.98 |
United Setting Professional Modifier None Typical Low $0.19 Median $0.22 Typical High $0.39 | Professional | None | $0.19 | $0.22 | $0.39 |
Wellmark Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
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 $0.17 Median $0.22 Typical High $0.22 | Professional | 52 · Reduced service | $0.17 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.09 Typical High $0.09 | Professional | 53 · Discontinued | $0.07 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.06 Typical High $0.07 | Professional | 55 · Aftercare only | $0.05 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.04 |
Where Iowa sits
The same service costs 2.5 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
$0.43
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.