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 $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $14.13 Typical High $16.60 | Professional | None | $12.88 | $14.13 | $16.60 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $20.89 Typical High $83.18 | Professional | None | $16.60 | $20.89 | $83.18 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $17.38 Typical High $75.86 | Facility | None | $14.45 | $17.38 | $75.86 |
Medica Setting Professional Modifier None Typical Low $17.38 Median $23.99 Typical High $91.20 | Professional | None | $17.38 | $23.99 | $91.20 |
Midlands Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $22.91 | Professional | None | $20.89 | $20.89 | $22.91 |
Midlands Setting Professional Modifier None Typical Low $17.38 Median $33.11 Typical High $38.02 | Professional | None | $17.38 | $33.11 | $38.02 |
United Setting Professional Modifier None Typical Low $14.45 Median $22.91 Typical High $40.74 | Professional | None | $14.45 | $22.91 | $40.74 |
Wellmark Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
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 $6.46 Median $7.08 Typical High $8.32 | Professional | 52 · Reduced service | $6.46 | $7.08 | $8.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.82 Typical High $3.31 | Professional | 53 · Discontinued | $2.57 | $2.82 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $2.14 Typical High $2.51 | Professional | 55 · Aftercare only | $1.91 | $2.14 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.45 Typical High $1.66 | Professional | 56 · Pre-op care only | $1.29 | $1.45 | $1.66 |
Where Iowa sits
The same service costs 4.9 times more in Alaska than in Connecticut. 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· 10th of 51
$20.89
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.