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 $0.79 Median $2.00 Typical High $2.00 | Facility | None | $0.79 | $2.00 | $2.00 |
Aetna Setting Professional Modifier None Typical Low $0.56 Median $0.56 Typical High $2.00 | Professional | None | $0.56 | $0.56 | $2.00 |
Cigna Setting Professional Modifier None Typical Low $0.55 Median $0.78 Typical High $0.78 | Professional | None | $0.55 | $0.78 | $0.78 |
Hally Health Setting Professional Modifier None Typical Low $0.31 Median $0.36 Typical High $0.52 | Professional | None | $0.31 | $0.36 | $0.52 |
Medica Setting Facility Modifier None Typical Low $0.60 Median $0.76 Typical High $2.63 | Facility | None | $0.60 | $0.76 | $2.63 |
Medica Setting Professional Modifier None Typical Low $0.45 Median $0.52 Typical High $0.78 | Professional | None | $0.45 | $0.52 | $0.78 |
Midlands Setting Professional Modifier None Typical Low $0.52 Median $0.78 Typical High $1.23 | Professional | None | $0.52 | $0.78 | $1.23 |
Midlands Setting Professional Modifier None Typical Low $0.65 Median $1.23 Typical High $1.23 | Professional | None | $0.65 | $1.23 | $1.23 |
Oscar Health Setting Professional Modifier None Typical Low $0.38 Median $0.71 Typical High $1.38 | Professional | None | $0.38 | $0.71 | $1.38 |
United Setting Professional Modifier None Typical Low $0.65 Median $0.68 Typical High $0.78 | Professional | None | $0.65 | $0.68 | $0.78 |
Wellmark Setting Facility Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Facility | None | $0.65 | $0.65 | $0.65 |
Wellmark Setting Professional Modifier None Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | None | $0.65 | $0.65 | $0.65 |
4 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 55 · Aftercare only Typical Low $0.10 Median $0.30 Typical High $0.30 | Facility | 55 · Aftercare only | $0.10 | $0.30 | $0.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.20 Typical High $0.20 | Facility | 56 · Pre-op care only | $0.07 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.30 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.20 |
Where Iowa sits
The same service costs 1.9 times more in Wyoming 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· 10th of 51
$0.65
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.