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 $4.68 Median $4.68 Typical High $4.68 | Facility | None | $4.68 | $4.68 | $4.68 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $4.68 Typical High $4.79 | Professional | None | $2.04 | $4.68 | $4.79 |
Cigna Setting Facility Modifier None Typical Low $2.69 Median $5.37 Typical High $5.37 | Facility | None | $2.69 | $5.37 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $5.37 Typical High $7.08 | Professional | None | $4.90 | $5.37 | $7.08 |
Hally Health Setting Professional Modifier None Typical Low $4.79 Median $5.50 Typical High $8.51 | Professional | None | $4.79 | $5.50 | $8.51 |
Medica Setting Facility Modifier None Typical Low $3.24 Median $5.25 Typical High $79.43 | Facility | None | $3.24 | $5.25 | $79.43 |
Medica Setting Professional Modifier None Typical Low $2.29 Median $4.07 Typical High $10.23 | Professional | None | $2.29 | $4.07 | $10.23 |
Midlands Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.50 | Professional | None | $5.37 | $5.37 | $5.50 |
Midlands Setting Professional Modifier None Typical Low $4.07 Median $7.94 Typical High $7.94 | Professional | None | $4.07 | $7.94 | $7.94 |
United Setting Professional Modifier None Typical Low $2.00 Median $2.34 Typical High $4.17 | Professional | None | $2.00 | $2.34 | $4.17 |
Wellmark Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | None | $4.57 | $4.57 | $4.57 |
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 $1.32 Median $2.34 Typical High $2.34 | Professional | 52 · Reduced service | $1.32 | $2.34 | $2.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.93 Typical High $0.95 | Professional | 53 · Discontinued | $0.52 | $0.93 | $0.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.40 Median $0.71 Typical High $0.71 | Professional | 55 · Aftercare only | $0.40 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.27 Median $0.47 Typical High $0.47 | Professional | 56 · Pre-op care only | $0.27 | $0.47 | $0.47 |
Where Iowa sits
The same service costs 2.2 times more in Kansas than in New Jersey. 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
$4.68
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.