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 $2.40 Median $2.40 Typical High $2.40 | Facility | None | $2.40 | $2.40 | $2.40 |
Aetna Setting Professional Modifier None Typical Low $1.20 Median $2.40 Typical High $2.45 | Professional | None | $1.20 | $2.40 | $2.45 |
Cigna Setting Professional Modifier None Typical Low $2.69 Median $2.75 Typical High $3.72 | Professional | None | $2.69 | $2.75 | $3.72 |
Hally Health Setting Professional Modifier None Typical Low $2.45 Median $2.69 Typical High $3.98 | Professional | None | $2.45 | $2.69 | $3.98 |
Medica Setting Facility Modifier None Typical Low $1.70 Median $2.69 Typical High $3.16 | Facility | None | $1.70 | $2.69 | $3.16 |
Medica Setting Professional Modifier None Typical Low $1.20 Median $2.09 Typical High $12.30 | Professional | None | $1.20 | $2.09 | $12.30 |
Midlands Setting Professional Modifier None Typical Low $2.75 Median $2.75 Typical High $3.24 | Professional | None | $2.75 | $2.75 | $3.24 |
Midlands Setting Professional Modifier None Typical Low $2.09 Median $3.55 Typical High $5.37 | Professional | None | $2.09 | $3.55 | $5.37 |
United Setting Professional Modifier None Typical Low $1.05 Median $1.23 Typical High $2.14 | Professional | None | $1.05 | $1.23 | $2.14 |
Wellmark Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
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 $0.91 Median $1.20 Typical High $1.23 | Professional | 52 · Reduced service | $0.91 | $1.20 | $1.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $0.48 Typical High $0.49 | Professional | 53 · Discontinued | $0.36 | $0.48 | $0.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.36 Typical High $0.37 | Professional | 55 · Aftercare only | $0.27 | $0.36 | $0.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.24 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.18 | $0.24 | $0.25 |
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· 6th of 51
$2.40
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.