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 $2.82 Median $2.82 Typical High $2.82 | Facility | None | $2.82 | $2.82 | $2.82 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $2.82 Typical High $2.88 | Professional | None | $1.23 | $2.82 | $2.88 |
Cigna Setting Facility Modifier None Typical Low $1.74 Median $3.24 Typical High $3.24 | Facility | None | $1.74 | $3.24 | $3.24 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $3.24 Typical High $4.27 | Professional | None | $2.95 | $3.24 | $4.27 |
Hally Health Setting Professional Modifier None Typical Low $2.75 Median $3.16 Typical High $5.75 | Professional | None | $2.75 | $3.16 | $5.75 |
Medica Setting Facility Modifier None Typical Low $2.00 Median $3.16 Typical High $79.43 | Facility | None | $2.00 | $3.16 | $79.43 |
Medica Setting Professional Modifier None Typical Low $1.41 Median $2.45 Typical High $6.31 | Professional | None | $1.41 | $2.45 | $6.31 |
Midlands Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.39 | Professional | None | $3.24 | $3.24 | $3.39 |
Midlands Setting Professional Modifier None Typical Low $2.51 Median $4.79 Typical High $4.79 | Professional | None | $2.51 | $4.79 | $4.79 |
United Setting Professional Modifier None Typical Low $1.23 Median $1.45 Typical High $2.51 | Professional | None | $1.23 | $1.45 | $2.51 |
Wellmark Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $2.82 | Professional | None | $2.82 | $2.82 | $2.82 |
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 $0.81 Median $1.41 Typical High $1.45 | Professional | 52 · Reduced service | $0.81 | $1.41 | $1.45 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.56 Typical High $0.58 | Professional | 53 · Discontinued | $0.32 | $0.56 | $0.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.42 Typical High $0.43 | Professional | 55 · Aftercare only | $0.24 | $0.42 | $0.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.28 Typical High $0.28 | Professional | 56 · Pre-op care only | $0.16 | $0.28 | $0.28 |
Where Iowa sits
The same service costs 2.2 times more in Kansas than in Alabama. 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· 9th of 51
$2.82
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.