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 $1.07 Median $1.07 Typical High $1.07 | Facility | None | $1.07 | $1.07 | $1.07 |
Aetna Setting Professional Modifier None Typical Low $0.81 Median $1.07 Typical High $1.10 | Professional | None | $0.81 | $1.07 | $1.10 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.23 Typical High $1.45 | Professional | None | $1.12 | $1.23 | $1.45 |
Hally Health Setting Professional Modifier None Typical Low $1.07 Median $1.20 Typical High $2.00 | Professional | None | $1.07 | $1.20 | $2.00 |
Medica Setting Facility Modifier None Typical Low $0.72 Median $1.20 Typical High $1.45 | Facility | None | $0.72 | $1.20 | $1.45 |
Medica Setting Professional Modifier None Typical Low $0.54 Median $0.93 Typical High $5.50 | Professional | None | $0.54 | $0.93 | $5.50 |
Midlands Setting Professional Modifier None Typical Low $1.23 Median $1.23 Typical High $1.45 | Professional | None | $1.23 | $1.23 | $1.45 |
Midlands Setting Professional Modifier None Typical Low $0.93 Median $1.58 Typical High $2.40 | Professional | None | $0.93 | $1.58 | $2.40 |
United Setting Professional Modifier None Typical Low $0.46 Median $0.55 Typical High $0.95 | Professional | None | $0.46 | $0.55 | $0.95 |
Wellmark Setting Professional Modifier None Typical Low $0.89 Median $0.89 Typical High $0.89 | Professional | None | $0.89 | $0.89 | $0.89 |
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 $0.41 Median $0.54 Typical High $0.55 | Professional | 52 · Reduced service | $0.41 | $0.54 | $0.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.22 Typical High $0.22 | Professional | 53 · Discontinued | $0.16 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.16 Typical High $0.17 | Professional | 55 · Aftercare only | $0.12 | $0.16 | $0.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.11 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.08 | $0.11 | $0.11 |
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· 7th of 51
$1.07
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.