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 $6.76 Median $18.20 Typical High $18.20 | Facility | None | $6.76 | $18.20 | $18.20 |
Aetna Setting Professional Modifier None Typical Low $6.76 Median $8.13 Typical High $18.20 | Professional | None | $6.76 | $8.13 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $3.02 Median $8.32 Typical High $10.23 | Professional | None | $3.02 | $8.32 | $10.23 |
Hally Health Setting Professional Modifier None Typical Low $1.78 Median $2.19 Typical High $8.91 | Professional | None | $1.78 | $2.19 | $8.91 |
Medica Setting Facility Modifier None Typical Low $2.24 Median $5.50 Typical High $43.65 | Facility | None | $2.24 | $5.50 | $43.65 |
Medica Setting Professional Modifier None Typical Low $3.09 Median $4.57 Typical High $7.94 | Professional | None | $3.09 | $4.57 | $7.94 |
Midlands Setting Professional Modifier None Typical Low $3.02 Median $3.98 Typical High $3.98 | Professional | None | $3.02 | $3.98 | $3.98 |
United Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $4.68 | Professional | None | $4.47 | $4.47 | $4.68 |
Wellmark Setting Facility Modifier None Typical Low $4.47 Median $4.47 Typical High $4.47 | Facility | None | $4.47 | $4.47 | $4.47 |
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 $3.39 Median $9.12 Typical High $9.12 | Facility | 52 · Reduced service | $3.39 | $9.12 | $9.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.35 Median $3.63 Typical High $3.63 | Facility | 53 · Discontinued | $1.35 | $3.63 | $3.63 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.00 Median $2.75 Typical High $2.75 | Facility | 55 · Aftercare only | $1.00 | $2.75 | $2.75 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.68 Median $1.82 Typical High $1.82 | Facility | 56 · Pre-op care only | $0.68 | $1.82 | $1.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.39 Median $4.07 Typical High $9.12 | Professional | 52 · Reduced service | $3.39 | $4.07 | $9.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.35 Median $1.62 Typical High $3.63 | Professional | 53 · Discontinued | $1.35 | $1.62 | $3.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.00 Median $1.20 Typical High $2.75 | Professional | 55 · Aftercare only | $1.00 | $1.20 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.68 Median $0.81 Typical High $1.82 | Professional | 56 · Pre-op care only | $0.68 | $0.81 | $1.82 |
Where Iowa sits
The same service costs 10.7 times more in Minnesota 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· 46th of 51
$4.57
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.