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 $5.13 Median $6.17 Typical High $7.76 | Facility | None | $5.13 | $6.17 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $6.17 Typical High $6.17 | Professional | None | $5.13 | $6.17 | $6.17 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | None | $5.50 | $5.50 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.62 Typical High $6.46 | Professional | None | $5.25 | $5.62 | $6.46 |
Hally Health Setting Professional Modifier None Typical Low $4.27 Median $5.50 Typical High $9.33 | Professional | None | $4.27 | $5.50 | $9.33 |
Medica Setting Facility Modifier None Typical Low $5.01 Median $6.17 Typical High $6.61 | Facility | None | $5.01 | $6.17 | $6.61 |
Medica Setting Professional Modifier None Typical Low $5.25 Median $5.37 Typical High $10.47 | Professional | None | $5.25 | $5.37 | $10.47 |
Midlands Setting Professional Modifier None Typical Low $5.62 Median $6.92 Typical High $6.92 | Professional | None | $5.62 | $6.92 | $6.92 |
United Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
United Setting Professional Modifier None Typical Low $5.13 Median $5.13 Typical High $5.50 | Professional | None | $5.13 | $5.13 | $5.50 |
Wellmark Setting Facility Modifier None Typical Low $5.13 Median $5.13 Typical High $5.13 | Facility | None | $5.13 | $5.13 | $5.13 |
8 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 Facility Modifier 52 · Reduced service Typical Low $2.57 Median $3.09 Typical High $3.89 | Facility | 52 · Reduced service | $2.57 | $3.09 | $3.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.02 Median $1.23 Typical High $1.55 | Facility | 53 · Discontinued | $1.02 | $1.23 | $1.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.78 Median $0.91 Typical High $1.15 | Facility | 55 · Aftercare only | $0.78 | $0.91 | $1.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.62 Typical High $0.78 | Facility | 56 · Pre-op care only | $0.51 | $0.62 | $0.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.57 Median $3.09 Typical High $3.09 | Professional | 52 · Reduced service | $2.57 | $3.09 | $3.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.02 Median $1.23 Typical High $1.23 | Professional | 53 · Discontinued | $1.02 | $1.23 | $1.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.78 Median $0.91 Typical High $0.91 | Professional | 55 · Aftercare only | $0.78 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.62 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.51 | $0.62 | $0.62 |
Where Iowa sits
The same service costs 1.7 times more in Arizona than in New Mexico. 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· 30th of 51
$5.25
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.