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 $7.08 Median $7.08 Typical High $19.95 | Facility | None | $7.08 | $7.08 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $7.08 Typical High $10.47 | Professional | None | $3.89 | $7.08 | $10.47 |
Cigna Setting Professional Modifier None Typical Low $3.98 Median $5.01 Typical High $10.00 | Professional | None | $3.98 | $5.01 | $10.00 |
Hally Health Setting Professional Modifier None Typical Low $5.62 Median $9.12 Typical High $16.98 | Professional | None | $5.62 | $9.12 | $16.98 |
Medica Setting Facility Modifier None Typical Low $2.00 Median $8.13 Typical High $11.48 | Facility | None | $2.00 | $8.13 | $11.48 |
Medica Setting Professional Modifier None Typical Low $3.98 Median $4.07 Typical High $12.88 | Professional | None | $3.98 | $4.07 | $12.88 |
Midlands Setting Professional Modifier None Typical Low $10.00 Median $12.59 Typical High $12.59 | Professional | None | $10.00 | $12.59 | $12.59 |
United Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $10.96 | Professional | None | $10.47 | $10.47 | $10.96 |
Wellmark Setting Facility Modifier None Typical Low $10.47 Median $10.47 Typical High $10.47 | Facility | None | $10.47 | $10.47 | $10.47 |
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 $3.55 Median $3.55 Typical High $7.76 | Facility | 52 · Reduced service | $3.55 | $3.55 | $7.76 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.41 Median $1.41 Typical High $3.16 | Facility | 53 · Discontinued | $1.41 | $1.41 | $3.16 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.07 Median $1.07 Typical High $2.34 | Facility | 55 · Aftercare only | $1.07 | $1.07 | $2.34 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.71 Median $0.71 Typical High $1.58 | Facility | 56 · Pre-op care only | $0.71 | $0.71 | $1.58 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.95 Median $3.55 Typical High $5.25 | Professional | 52 · Reduced service | $1.95 | $3.55 | $5.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $1.41 Typical High $2.04 | Professional | 53 · Discontinued | $0.78 | $1.41 | $2.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.59 Median $1.07 Typical High $1.55 | Professional | 55 · Aftercare only | $0.59 | $1.07 | $1.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.71 Typical High $1.05 | Professional | 56 · Pre-op care only | $0.39 | $0.71 | $1.05 |
Where Iowa sits
The same service costs 3.2 times more in Hawaii 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· 6th of 51
$10.00
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.