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 $2.09 Median $2.34 Typical High $2.95 | Facility | None | $2.09 | $2.34 | $2.95 |
Aetna Setting Professional Modifier None Typical Low $2.09 Median $2.34 Typical High $2.34 | Professional | None | $2.09 | $2.34 | $2.34 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.69 | Professional | None | $2.14 | $2.14 | $2.69 |
Hally Health Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $10.47 | Professional | None | $1.95 | $1.95 | $10.47 |
Medica Setting Facility Modifier None Typical Low $1.91 Median $2.19 Typical High $2.34 | Facility | None | $1.91 | $2.19 | $2.34 |
Medica Setting Professional Modifier None Typical Low $1.91 Median $1.95 Typical High $4.17 | Professional | None | $1.91 | $1.95 | $4.17 |
Midlands Setting Professional Modifier None Typical Low $2.14 Median $2.51 Typical High $2.51 | Professional | None | $2.14 | $2.51 | $2.51 |
United Setting Facility Modifier None Typical Low $2.09 Median $2.09 Typical High $2.09 | Facility | None | $2.09 | $2.09 | $2.09 |
United Setting Professional Modifier None Typical Low $1.95 Median $1.95 Typical High $2.09 | Professional | None | $1.95 | $1.95 | $2.09 |
Wellmark Setting Facility Modifier None Typical Low $1.95 Median $1.95 Typical High $1.95 | Facility | None | $1.95 | $1.95 | $1.95 |
10 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 $1.05 Median $1.17 Typical High $1.48 | Facility | 52 · Reduced service | $1.05 | $1.17 | $1.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.42 Median $0.47 Typical High $0.59 | Facility | 53 · Discontinued | $0.42 | $0.47 | $0.59 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $1.55 Median $1.78 Typical High $2.24 | Facility | 54 · Surgery only | $1.55 | $1.78 | $2.24 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.31 Median $0.35 Typical High $0.44 | Facility | 55 · Aftercare only | $0.31 | $0.35 | $0.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.24 Typical High $0.30 | Facility | 56 · Pre-op care only | $0.21 | $0.24 | $0.30 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.05 Median $1.17 Typical High $1.17 | Professional | 52 · Reduced service | $1.05 | $1.17 | $1.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.42 Median $0.47 Typical High $0.47 | Professional | 53 · Discontinued | $0.42 | $0.47 | $0.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.55 Median $1.78 Typical High $1.78 | Professional | 54 · Surgery only | $1.55 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.31 Median $0.35 Typical High $0.35 | Professional | 55 · Aftercare only | $0.31 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.24 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.21 | $0.24 | $0.24 |
Where Iowa sits
The same service costs 1.6 times more in Alaska than in Iowa. 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· 51st of 51
$1.95
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.