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 $12.02 Median $12.02 Typical High $12.02 | Facility | None | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier None Typical Low $9.55 Median $10.23 Typical High $12.02 | Professional | None | $9.55 | $10.23 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $28.84 Typical High $35.48 | Professional | None | $28.18 | $28.84 | $35.48 |
Hally Health Setting Professional Modifier None Typical Low $22.91 Median $42.66 Typical High $42.66 | Professional | None | $22.91 | $42.66 | $42.66 |
Medica Setting Facility Modifier None Typical Low $12.88 Median $25.70 Typical High $51.29 | Facility | None | $12.88 | $25.70 | $51.29 |
Medica Setting Professional Modifier None Typical Low $10.72 Median $11.22 Typical High $52.48 | Professional | None | $10.72 | $11.22 | $52.48 |
Midlands Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $28.84 | Professional | None | $26.92 | $26.92 | $28.84 |
United Setting Facility Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
United Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $10.96 | Professional | None | $10.00 | $10.00 | $10.96 |
Wellmark Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Facility | None | $11.22 | $11.22 | $11.22 |
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 $6.03 Median $6.03 Typical High $6.03 | Facility | 52 · Reduced service | $6.03 | $6.03 | $6.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.40 Median $2.40 Typical High $2.40 | Facility | 53 · Discontinued | $2.40 | $2.40 | $2.40 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.82 Median $1.82 Typical High $1.82 | Facility | 55 · Aftercare only | $1.82 | $1.82 | $1.82 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.20 Median $1.20 Typical High $1.20 | Facility | 56 · Pre-op care only | $1.20 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.79 Median $5.13 Typical High $6.03 | Professional | 52 · Reduced service | $4.79 | $5.13 | $6.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.91 Median $2.04 Typical High $2.40 | Professional | 53 · Discontinued | $1.91 | $2.04 | $2.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.51 Typical High $1.82 | Professional | 55 · Aftercare only | $1.45 | $1.51 | $1.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.95 Median $1.02 Typical High $1.20 | Professional | 56 · Pre-op care only | $0.95 | $1.02 | $1.20 |
Where Iowa sits
The same service costs 9.1 times more in Alabama than in Virginia. 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· 24th of 51
$11.22
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.