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 $1.23 Median $2.04 Typical High $2.40 | Facility | None | $1.23 | $2.04 | $2.40 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.66 Typical High $2.04 | Professional | None | $1.23 | $1.66 | $2.04 |
Cigna Setting Professional Modifier None Typical Low $1.23 Median $1.55 Typical High $1.66 | Professional | None | $1.23 | $1.55 | $1.66 |
Hally Health Setting Professional Modifier None Typical Low $1.07 Median $1.07 Typical High $8.32 | Professional | None | $1.07 | $1.07 | $8.32 |
Medica Setting Facility Modifier None Typical Low $1.35 Median $1.82 Typical High $7.94 | Facility | None | $1.35 | $1.82 | $7.94 |
Medica Setting Professional Modifier None Typical Low $1.12 Median $1.17 Typical High $4.17 | Professional | None | $1.12 | $1.17 | $4.17 |
Midlands Setting Professional Modifier None Typical Low $1.41 Median $1.41 Typical High $1.86 | Professional | None | $1.41 | $1.41 | $1.86 |
United Setting Professional Modifier None Typical Low $1.10 Median $1.10 Typical High $1.15 | Professional | None | $1.10 | $1.10 | $1.15 |
Wellmark Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $1.10 | Facility | None | $1.10 | $1.10 | $1.10 |
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 $0.62 Median $1.00 Typical High $1.00 | Facility | 52 · Reduced service | $0.62 | $1.00 | $1.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.24 Median $0.40 Typical High $0.40 | Facility | 53 · Discontinued | $0.24 | $0.40 | $0.40 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.18 Median $0.30 Typical High $0.30 | Facility | 55 · Aftercare only | $0.18 | $0.30 | $0.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.20 Typical High $0.20 | Facility | 56 · Pre-op care only | $0.12 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.62 Median $0.81 Typical High $1.00 | Professional | 52 · Reduced service | $0.62 | $0.81 | $1.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.24 Median $0.33 Typical High $0.40 | Professional | 53 · Discontinued | $0.24 | $0.33 | $0.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.25 Typical High $0.30 | Professional | 55 · Aftercare only | $0.18 | $0.25 | $0.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.16 Typical High $0.20 | Professional | 56 · Pre-op care only | $0.12 | $0.16 | $0.20 |
Where Iowa sits
The same service costs 3.8 times more in Texas than in Maryland. 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
$1.17
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.