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 $5.62 Median $6.92 Typical High $8.51 | Facility | None | $5.62 | $6.92 | $8.51 |
Aetna Setting Professional Modifier None Typical Low $5.62 Median $6.92 Typical High $6.92 | Professional | None | $5.62 | $6.92 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Facility | None | $5.75 | $5.75 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $5.75 Median $6.31 Typical High $7.08 | Professional | None | $5.75 | $6.31 | $7.08 |
Hally Health Setting Professional Modifier None Typical Low $4.79 Median $5.62 Typical High $14.13 | Professional | None | $4.79 | $5.62 | $14.13 |
Medica Setting Facility Modifier None Typical Low $5.75 Median $6.61 Typical High $7.24 | Facility | None | $5.75 | $6.61 | $7.24 |
Medica Setting Professional Modifier None Typical Low $5.62 Median $5.75 Typical High $12.30 | Professional | None | $5.62 | $5.75 | $12.30 |
Midlands Setting Professional Modifier None Typical Low $6.31 Median $7.41 Typical High $7.41 | Professional | None | $6.31 | $7.41 | $7.41 |
United Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
United Setting Professional Modifier None Typical Low $5.62 Median $5.62 Typical High $6.03 | Professional | None | $5.62 | $5.62 | $6.03 |
Wellmark Setting Facility Modifier None Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | None | $5.62 | $5.62 | $5.62 |
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 $2.82 Median $3.47 Typical High $4.27 | Facility | 52 · Reduced service | $2.82 | $3.47 | $4.27 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.12 Median $1.38 Typical High $1.70 | Facility | 53 · Discontinued | $1.12 | $1.38 | $1.70 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.85 Median $1.05 Typical High $1.29 | Facility | 55 · Aftercare only | $0.85 | $1.05 | $1.29 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.69 Typical High $0.85 | Facility | 56 · Pre-op care only | $0.56 | $0.69 | $0.85 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.82 Median $3.47 Typical High $3.47 | Professional | 52 · Reduced service | $2.82 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.38 Typical High $1.38 | Professional | 53 · Discontinued | $1.12 | $1.38 | $1.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.83 Median $1.05 Typical High $1.05 | Professional | 55 · Aftercare only | $0.83 | $1.05 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.69 Typical High $0.69 | Professional | 56 · Pre-op care only | $0.56 | $0.69 | $0.69 |
Where Iowa sits
The same service costs 1.7 times more in Arizona than in Vermont. 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· 28th of 51
$5.75
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.