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 $0.65 Median $2.95 Typical High $2.95 | Facility | None | $0.65 | $2.95 | $2.95 |
Aetna Setting Professional Modifier None Typical Low $0.62 Median $0.71 Typical High $2.95 | Professional | None | $0.62 | $0.71 | $2.95 |
Cigna Setting Professional Modifier None Typical Low $0.65 Median $0.79 Typical High $0.79 | Professional | None | $0.65 | $0.79 | $0.79 |
Hally Health Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $4.27 | Professional | None | $0.55 | $0.55 | $4.27 |
Medica Setting Facility Modifier None Typical Low $0.83 Median $0.91 Typical High $2.57 | Facility | None | $0.83 | $0.91 | $2.57 |
Medica Setting Professional Modifier None Typical Low $0.49 Median $0.52 Typical High $2.29 | Professional | None | $0.49 | $0.52 | $2.29 |
Midlands Setting Professional Modifier None Typical Low $0.78 Median $0.78 Typical High $0.89 | Professional | None | $0.78 | $0.78 | $0.89 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.71 | Professional | None | $0.65 | $0.65 | $0.71 |
Wellmark Setting Facility Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Facility | None | $0.65 | $0.65 | $0.65 |
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 $0.32 Median $1.48 Typical High $1.48 | Facility | 52 · Reduced service | $0.32 | $1.48 | $1.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.13 Median $0.59 Typical High $0.59 | Facility | 53 · Discontinued | $0.13 | $0.59 | $0.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.10 Median $0.44 Typical High $0.44 | Facility | 55 · Aftercare only | $0.10 | $0.44 | $0.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.30 Typical High $0.30 | Facility | 56 · Pre-op care only | $0.06 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.31 Median $0.48 Typical High $1.48 | Professional | 52 · Reduced service | $0.31 | $0.48 | $1.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.12 Median $0.19 Typical High $0.59 | Professional | 53 · Discontinued | $0.12 | $0.19 | $0.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.14 Typical High $0.44 | Professional | 55 · Aftercare only | $0.09 | $0.14 | $0.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.10 Typical High $0.30 | Professional | 56 · Pre-op care only | $0.06 | $0.10 | $0.30 |
Where Iowa sits
The same service costs 4.7 times more in Wyoming than in Georgia. 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· 41st of 51
$0.65
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.