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 $0.52 Median $0.52 Typical High $0.52 | Facility | None | $0.52 | $0.52 | $0.52 |
Aetna Setting Professional Modifier None Typical Low $0.40 Median $0.52 Typical High $0.54 | Professional | None | $0.40 | $0.52 | $0.54 |
Cigna Setting Professional Modifier None Typical Low $0.59 Median $0.62 Typical High $0.93 | Professional | None | $0.59 | $0.62 | $0.93 |
Hally Health Setting Professional Modifier None Typical Low $0.54 Median $0.63 Typical High $0.83 | Professional | None | $0.54 | $0.63 | $0.83 |
Medica Setting Facility Modifier None Typical Low $0.39 Median $0.62 Typical High $1.00 | Facility | None | $0.39 | $0.62 | $1.00 |
Medica Setting Professional Modifier None Typical Low $0.28 Median $0.48 Typical High $2.69 | Professional | None | $0.28 | $0.48 | $2.69 |
Midlands Setting Professional Modifier None Typical Low $0.62 Median $0.62 Typical High $0.72 | Professional | None | $0.62 | $0.62 | $0.72 |
Midlands Setting Professional Modifier None Typical Low $0.49 Median $0.79 Typical High $1.20 | Professional | None | $0.49 | $0.79 | $1.20 |
United Setting Professional Modifier None Typical Low $0.23 Median $0.28 Typical High $0.48 | Professional | None | $0.23 | $0.28 | $0.48 |
Wellmark Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | None | $0.44 | $0.44 | $0.44 |
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 $0.20 Median $0.27 Typical High $0.27 | Professional | 52 · Reduced service | $0.20 | $0.27 | $0.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.11 Typical High $0.11 | Professional | 53 · Discontinued | $0.08 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.08 Typical High $0.08 | Professional | 55 · Aftercare only | $0.06 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.04 | $0.05 | $0.05 |
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· 8th of 51
$0.52
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.