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 $0.85 Median $0.85 Typical High $0.85 | Facility | None | $0.85 | $0.85 | $0.85 |
Aetna Setting Professional Modifier None Typical Low $0.56 Median $0.85 Typical High $0.87 | Professional | None | $0.56 | $0.85 | $0.87 |
Cigna Setting Professional Modifier None Typical Low $0.95 Median $1.00 Typical High $1.41 | Professional | None | $0.95 | $1.00 | $1.41 |
Hally Health Setting Professional Modifier None Typical Low $0.87 Median $0.93 Typical High $1.45 | Professional | None | $0.87 | $0.93 | $1.45 |
Medica Setting Facility Modifier None Typical Low $0.59 Median $0.98 Typical High $1.12 | Facility | None | $0.59 | $0.98 | $1.12 |
Medica Setting Professional Modifier None Typical Low $0.43 Median $0.76 Typical High $4.37 | Professional | None | $0.43 | $0.76 | $4.37 |
Midlands Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.17 | Professional | None | $1.00 | $1.00 | $1.17 |
Midlands Setting Professional Modifier None Typical Low $0.74 Median $1.26 Typical High $1.91 | Professional | None | $0.74 | $1.26 | $1.91 |
United Setting Professional Modifier None Typical Low $0.37 Median $0.44 Typical High $0.78 | Professional | None | $0.37 | $0.44 | $0.78 |
Wellmark Setting Professional Modifier None Typical Low $0.72 Median $0.72 Typical High $0.72 | Professional | None | $0.72 | $0.72 | $0.72 |
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 $0.33 Median $0.43 Typical High $0.44 | Professional | 52 · Reduced service | $0.33 | $0.43 | $0.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.17 Typical High $0.18 | Professional | 53 · Discontinued | $0.13 | $0.17 | $0.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.13 Typical High $0.13 | Professional | 55 · Aftercare only | $0.10 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.09 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.07 | $0.09 | $0.09 |
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
$0.85
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.