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 $0.54 Median $1.55 Typical High $1.55 | Facility | None | $0.54 | $1.55 | $1.55 |
Aetna Setting Professional Modifier None Typical Low $0.54 Median $0.81 Typical High $1.55 | Professional | None | $0.54 | $0.81 | $1.55 |
Cigna Setting Professional Modifier None Typical Low $0.56 Median $0.71 Typical High $0.87 | Professional | None | $0.56 | $0.71 | $0.87 |
Hally Health Setting Professional Modifier None Typical Low $0.59 Median $1.07 Typical High $9.55 | Professional | None | $0.59 | $1.07 | $9.55 |
Medica Setting Facility Modifier None Typical Low $0.68 Median $1.00 Typical High $6.31 | Facility | None | $0.68 | $1.00 | $6.31 |
Medica Setting Professional Modifier None Typical Low $0.56 Median $0.60 Typical High $2.09 | Professional | None | $0.56 | $0.60 | $2.09 |
Midlands Setting Professional Modifier None Typical Low $0.69 Median $0.69 Typical High $1.00 | Professional | None | $0.69 | $0.69 | $1.00 |
United Setting Professional Modifier None Typical Low $0.54 Median $0.54 Typical High $0.59 | Professional | None | $0.54 | $0.54 | $0.59 |
Wellmark Setting Facility Modifier None Typical Low $0.54 Median $0.54 Typical High $0.54 | Facility | None | $0.54 | $0.54 | $0.54 |
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 $0.27 Median $0.78 Typical High $0.78 | Facility | 52 · Reduced service | $0.27 | $0.78 | $0.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.11 Median $0.31 Typical High $0.31 | Facility | 53 · Discontinued | $0.11 | $0.31 | $0.31 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.08 Median $0.23 Typical High $0.23 | Facility | 55 · Aftercare only | $0.08 | $0.23 | $0.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.16 Typical High $0.16 | Facility | 56 · Pre-op care only | $0.05 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.27 Median $0.41 Typical High $0.78 | Professional | 52 · Reduced service | $0.27 | $0.41 | $0.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.11 Median $0.16 Typical High $0.31 | Professional | 53 · Discontinued | $0.11 | $0.16 | $0.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.08 Median $0.12 Typical High $0.23 | Professional | 55 · Aftercare only | $0.08 | $0.12 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.08 Typical High $0.16 | Professional | 56 · Pre-op care only | $0.05 | $0.08 | $0.16 |
Where Iowa sits
The same service costs 6.3 times more in Texas than in Mississippi. 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· 33rd of 51
$0.56
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.