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 $5.37 Median $9.55 Typical High $9.55 | Facility | None | $5.37 | $9.55 | $9.55 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $3.80 Typical High $9.55 | Professional | None | $2.95 | $3.80 | $9.55 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.72 | Professional | None | $3.02 | $3.02 | $3.72 |
Hally Health Setting Professional Modifier None Typical Low $1.74 Median $3.24 Typical High $6.03 | Professional | None | $1.74 | $3.24 | $6.03 |
Medica Setting Facility Modifier None Typical Low $1.00 Median $5.01 Typical High $9.55 | Facility | None | $1.00 | $5.01 | $9.55 |
Medica Setting Professional Modifier None Typical Low $3.98 Median $4.37 Typical High $7.08 | Professional | None | $3.98 | $4.37 | $7.08 |
Midlands Setting Professional Modifier None Typical Low $4.47 Median $5.01 Typical High $5.01 | Professional | None | $4.47 | $5.01 | $5.01 |
United Setting Professional Modifier None Typical Low $3.63 Median $3.98 Typical High $4.37 | Professional | None | $3.63 | $3.98 | $4.37 |
Wellmark Setting Facility Modifier None Typical Low $3.63 Median $3.63 Typical High $3.63 | Facility | None | $3.63 | $3.63 | $3.63 |
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 $1.82 Median $4.79 Typical High $4.79 | Facility | 52 · Reduced service | $1.82 | $4.79 | $4.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.72 Median $1.91 Typical High $1.91 | Facility | 53 · Discontinued | $0.72 | $1.91 | $1.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.54 Median $1.45 Typical High $1.45 | Facility | 55 · Aftercare only | $0.54 | $1.45 | $1.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.95 Typical High $0.95 | Facility | 56 · Pre-op care only | $0.36 | $0.95 | $0.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.48 Median $2.69 Typical High $4.79 | Professional | 52 · Reduced service | $1.48 | $2.69 | $4.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $1.07 Typical High $1.91 | Professional | 53 · Discontinued | $0.59 | $1.07 | $1.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.81 Typical High $1.45 | Professional | 55 · Aftercare only | $0.44 | $0.81 | $1.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.54 Typical High $0.95 | Professional | 56 · Pre-op care only | $0.28 | $0.54 | $0.95 |
Where Iowa sits
The same service costs 2.8 times more in Wyoming than in Florida. 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· 11th of 51
$3.98
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.