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 $3.55 Median $10.00 Typical High $10.00 | Facility | None | $3.55 | $10.00 | $10.00 |
Aetna Setting Professional Modifier None Typical Low $3.55 Median $5.13 Typical High $10.00 | Professional | None | $3.55 | $5.13 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $3.63 Median $4.57 Typical High $7.94 | Professional | None | $3.63 | $4.57 | $7.94 |
Hally Health Setting Professional Modifier None Typical Low $3.55 Median $4.47 Typical High $8.13 | Professional | None | $3.55 | $4.47 | $8.13 |
Medica Setting Facility Modifier None Typical Low $3.02 Median $5.89 Typical High $10.00 | Facility | None | $3.02 | $5.89 | $10.00 |
Medica Setting Professional Modifier None Typical Low $3.89 Median $4.17 Typical High $26.92 | Professional | None | $3.89 | $4.17 | $26.92 |
Midlands Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $8.91 | Professional | None | $4.47 | $4.47 | $8.91 |
United Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $3.72 | Professional | None | $3.39 | $3.39 | $3.72 |
Wellmark Setting Facility Modifier None Typical Low $3.39 Median $3.39 Typical High $3.39 | Facility | None | $3.39 | $3.39 | $3.39 |
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 $1.78 Median $5.01 Typical High $5.01 | Facility | 52 · Reduced service | $1.78 | $5.01 | $5.01 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.71 Median $2.00 Typical High $2.00 | Facility | 53 · Discontinued | $0.71 | $2.00 | $2.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.52 Median $1.51 Typical High $1.51 | Facility | 55 · Aftercare only | $0.52 | $1.51 | $1.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.36 Median $1.00 Typical High $1.00 | Facility | 56 · Pre-op care only | $0.36 | $1.00 | $1.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.78 Median $2.57 Typical High $5.01 | Professional | 52 · Reduced service | $1.78 | $2.57 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $1.02 Typical High $2.00 | Professional | 53 · Discontinued | $0.71 | $1.02 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.78 Typical High $1.51 | Professional | 55 · Aftercare only | $0.52 | $0.78 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.36 Median $0.51 Typical High $1.00 | Professional | 56 · Pre-op care only | $0.36 | $0.51 | $1.00 |
Where Iowa sits
The same service costs 4.0 times more in Oklahoma 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· 22nd of 51
$3.89
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.