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 $2.88 Median $3.31 Typical High $4.27 | Facility | None | $2.88 | $3.31 | $4.27 |
Aetna Setting Professional Modifier None Typical Low $1.95 Median $2.19 Typical High $3.31 | Professional | None | $1.95 | $2.19 | $3.31 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $2.45 Typical High $3.02 | Professional | None | $2.00 | $2.45 | $3.02 |
Hally Health Setting Professional Modifier None Typical Low $1.74 Median $2.19 Typical High $4.90 | Professional | None | $1.74 | $2.19 | $4.90 |
Medica Setting Facility Modifier None Typical Low $1.00 Median $2.95 Typical High $3.39 | Facility | None | $1.00 | $2.95 | $3.39 |
Medica Setting Professional Modifier None Typical Low $2.09 Median $2.63 Typical High $4.68 | Professional | None | $2.09 | $2.63 | $4.68 |
Midlands Setting Professional Modifier None Typical Low $2.82 Median $2.82 Typical High $3.47 | Professional | None | $2.82 | $2.82 | $3.47 |
United Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.14 | Professional | None | $1.95 | $1.95 | $2.14 |
Wellmark Setting Facility Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Facility | None | $1.95 | $1.95 | $1.95 |
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 $0.98 Median $1.66 Typical High $1.66 | Facility | 52 · Reduced service | $0.98 | $1.66 | $1.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.39 Median $0.66 Typical High $0.66 | Facility | 53 · Discontinued | $0.39 | $0.66 | $0.66 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.28 Median $0.50 Typical High $0.50 | Facility | 55 · Aftercare only | $0.28 | $0.50 | $0.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.33 Typical High $0.33 | Facility | 56 · Pre-op care only | $0.19 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.98 Median $1.45 Typical High $1.66 | Professional | 52 · Reduced service | $0.98 | $1.45 | $1.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.39 Median $0.58 Typical High $0.66 | Professional | 53 · Discontinued | $0.39 | $0.58 | $0.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.44 Typical High $0.50 | Professional | 55 · Aftercare only | $0.28 | $0.44 | $0.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.28 Typical High $0.33 | Professional | 56 · Pre-op care only | $0.19 | $0.28 | $0.33 |
Where Iowa sits
The same service costs 2.5 times more in Texas than in Tennessee. 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· 15th of 51
$2.19
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.