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 $0.09 Median $0.14 Typical High $0.17 | Facility | None | $0.09 | $0.14 | $0.17 |
Aetna Setting Facility Modifier 52 · Reduced service Typical Low $0.05 Median $0.07 Typical High $0.07 | Facility | 52 · Reduced service | $0.05 | $0.07 | $0.07 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.02 Median $0.03 Typical High $0.03 | Facility | 53 · Discontinued | $0.02 | $0.03 | $0.03 |
Aetna Setting Professional Modifier None Typical Low $0.09 Median $0.10 Typical High $0.14 | Professional | None | $0.09 | $0.10 | $0.14 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.05 Median $0.07 Typical High $0.07 | Professional | 52 · Reduced service | $0.05 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 53 · Discontinued | $0.02 | $0.03 | $0.03 |
Cigna Setting Professional Modifier None Typical Low $0.08 Median $0.09 Typical High $0.15 | Professional | None | $0.08 | $0.09 | $0.15 |
Hally Health Setting Professional Modifier None Typical Low $0.07 Median $0.09 Typical High $0.83 | Professional | None | $0.07 | $0.09 | $0.83 |
Medica Setting Facility Modifier None Typical Low $0.10 Median $0.89 Typical High $3.72 | Facility | None | $0.10 | $0.89 | $3.72 |
Medica Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $0.31 | Professional | None | $0.09 | $0.09 | $0.31 |
Midlands Setting Professional Modifier None Typical Low $0.12 Median $0.12 Typical High $0.17 | Professional | None | $0.12 | $0.12 | $0.17 |
United Setting Professional Modifier None Typical Low $0.09 Median $0.09 Typical High $0.10 | Professional | None | $0.09 | $0.09 | $0.10 |
Wellmark Setting Facility Modifier None Typical Low $0.09 Median $0.09 Typical High $0.09 | Facility | None | $0.09 | $0.09 | $0.09 |
1 more rate 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 $0.02 Median $0.02 Typical High $0.02 | Facility | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Where Iowa sits
The same service costs 14.5 times more in Alaska than in New Jersey. 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· 30th of 51
$0.10
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.