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 $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $8.13 Typical High $8.32 | Professional | None | $5.62 | $8.13 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $9.12 Median $9.33 Typical High $11.75 | Professional | None | $9.12 | $9.33 | $11.75 |
Hally Health Setting Professional Modifier None Typical Low $7.76 Median $8.91 Typical High $10.23 | Professional | None | $7.76 | $8.91 | $10.23 |
Medica Setting Facility Modifier None Typical Low $5.62 Median $9.12 Typical High $10.72 | Facility | None | $5.62 | $9.12 | $10.72 |
Medica Setting Professional Modifier None Typical Low $4.07 Median $7.08 Typical High $40.74 | Professional | None | $4.07 | $7.08 | $40.74 |
Midlands Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $10.96 | Professional | None | $9.33 | $9.33 | $10.96 |
Midlands Setting Professional Modifier None Typical Low $7.08 Median $11.75 Typical High $17.78 | Professional | None | $7.08 | $11.75 | $17.78 |
United Setting Professional Modifier None Typical Low $3.47 Median $4.07 Typical High $7.24 | Professional | None | $3.47 | $4.07 | $7.24 |
Wellmark Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
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 $3.02 Median $4.07 Typical High $4.07 | Professional | 52 · Reduced service | $3.02 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.62 Typical High $1.66 | Professional | 53 · Discontinued | $1.23 | $1.62 | $1.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $1.20 Typical High $1.23 | Professional | 55 · Aftercare only | $0.91 | $1.20 | $1.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.81 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.62 | $0.81 | $0.81 |
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
$8.13
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.