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 $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.55 Typical High $3.89 | Professional | None | $3.24 | $3.55 | $3.89 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $3.47 Typical High $4.17 | Professional | None | $3.31 | $3.47 | $4.17 |
Hally Health Setting Professional Modifier None Typical Low $3.09 Median $3.09 Typical High $16.98 | Professional | None | $3.09 | $3.09 | $16.98 |
Medica Setting Facility Modifier None Typical Low $2.69 Median $3.55 Typical High $3.63 | Facility | None | $2.69 | $3.55 | $3.63 |
Medica Setting Professional Modifier None Typical Low $3.02 Median $3.02 Typical High $3.55 | Professional | None | $3.02 | $3.02 | $3.55 |
Midlands Setting Professional Modifier None Typical Low $3.47 Median $4.17 Typical High $4.17 | Professional | None | $3.47 | $4.17 | $4.17 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.39 | Professional | None | $3.16 | $3.16 | $3.39 |
Wellmark Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
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 $1.95 Median $1.95 Typical High $1.95 | Facility | 52 · Reduced service | $1.95 | $1.95 | $1.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.78 Median $0.78 Typical High $0.78 | Facility | 53 · Discontinued | $0.78 | $0.78 | $0.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.58 Median $0.58 Typical High $0.58 | Facility | 55 · Aftercare only | $0.58 | $0.58 | $0.58 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.39 Typical High $0.39 | Facility | 56 · Pre-op care only | $0.39 | $0.39 | $0.39 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.62 Median $1.70 Typical High $1.95 | Professional | 52 · Reduced service | $1.62 | $1.70 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.68 Typical High $0.78 | Professional | 53 · Discontinued | $0.65 | $0.68 | $0.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.50 Typical High $0.58 | Professional | 55 · Aftercare only | $0.49 | $0.50 | $0.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.34 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.33 | $0.34 | $0.39 |
Where Iowa sits
The same service costs 2.0 times more in Arizona 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
$3.16
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.