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 $4.37 Median $7.08 Typical High $7.08 | Facility | None | $4.37 | $7.08 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $4.37 Median $6.46 Typical High $7.08 | Professional | None | $4.37 | $6.46 | $7.08 |
Cigna Setting Professional Modifier None Typical Low $4.47 Median $4.68 Typical High $5.62 | Professional | None | $4.47 | $4.68 | $5.62 |
Hally Health Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $8.51 | Professional | None | $4.27 | $4.27 | $8.51 |
Medica Setting Facility Modifier None Typical Low $2.95 Median $4.79 Typical High $7.76 | Facility | None | $2.95 | $4.79 | $7.76 |
Medica Setting Professional Modifier None Typical Low $3.47 Median $4.27 Typical High $7.59 | Professional | None | $3.47 | $4.27 | $7.59 |
Midlands Setting Professional Modifier None Typical Low $4.68 Median $5.50 Typical High $5.50 | Professional | None | $4.68 | $5.50 | $5.50 |
United Setting Facility Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Facility | None | $4.37 | $4.37 | $4.37 |
United Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.47 | Professional | None | $4.27 | $4.27 | $4.47 |
Wellmark Setting Facility Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Facility | None | $4.27 | $4.27 | $4.27 |
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 $2.19 Median $3.55 Typical High $3.55 | Facility | 52 · Reduced service | $2.19 | $3.55 | $3.55 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.87 Median $1.41 Typical High $1.41 | Facility | 53 · Discontinued | $0.87 | $1.41 | $1.41 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.66 Median $1.05 Typical High $1.05 | Facility | 55 · Aftercare only | $0.66 | $1.05 | $1.05 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.71 Typical High $0.71 | Facility | 56 · Pre-op care only | $0.44 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.19 Median $3.24 Typical High $3.55 | Professional | 52 · Reduced service | $2.19 | $3.24 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.87 Median $1.29 Typical High $1.41 | Professional | 53 · Discontinued | $0.87 | $1.29 | $1.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.66 Median $0.95 Typical High $1.05 | Professional | 55 · Aftercare only | $0.66 | $0.95 | $1.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.44 Median $0.65 Typical High $0.71 | Professional | 56 · Pre-op care only | $0.44 | $0.65 | $0.71 |
Where Iowa sits
The same service costs 2.7 times more in Alaska than in Oklahoma. 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· 48th of 51
$4.27
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.