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 $4.37 Median $20.89 Typical High $20.89 | Facility | None | $4.37 | $20.89 | $20.89 |
Aetna Setting Professional Modifier None Typical Low $2.82 Median $4.47 Typical High $20.89 | Professional | None | $2.82 | $4.47 | $20.89 |
Cigna Setting Professional Modifier None Typical Low $1.62 Median $2.88 Typical High $3.63 | Professional | None | $1.62 | $2.88 | $3.63 |
Hally Health Setting Professional Modifier None Typical Low $2.69 Median $7.41 Typical High $13.49 | Professional | None | $2.69 | $7.41 | $13.49 |
Medica Setting Facility Modifier None Typical Low $1.58 Median $2.57 Typical High $20.89 | Facility | None | $1.58 | $2.57 | $20.89 |
Medica Setting Professional Modifier None Typical Low $1.70 Median $2.75 Typical High $10.72 | Professional | None | $1.70 | $2.75 | $10.72 |
Midlands Setting Professional Modifier None Typical Low $1.62 Median $3.24 Typical High $3.24 | Professional | None | $1.62 | $3.24 | $3.24 |
United Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $3.24 | Professional | None | $2.95 | $2.95 | $3.24 |
Wellmark Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Facility | None | $2.95 | $2.95 | $2.95 |
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 $1.48 Median $10.47 Typical High $10.47 | Facility | 52 · Reduced service | $1.48 | $10.47 | $10.47 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.59 Median $4.17 Typical High $4.17 | Facility | 53 · Discontinued | $0.59 | $4.17 | $4.17 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.44 Median $3.16 Typical High $3.16 | Facility | 55 · Aftercare only | $0.44 | $3.16 | $3.16 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.30 Median $2.09 Typical High $2.09 | Facility | 56 · Pre-op care only | $0.30 | $2.09 | $2.09 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.41 Median $2.24 Typical High $10.47 | Professional | 52 · Reduced service | $1.41 | $2.24 | $10.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.56 Median $0.89 Typical High $4.17 | Professional | 53 · Discontinued | $0.56 | $0.89 | $4.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.42 Median $0.68 Typical High $3.16 | Professional | 55 · Aftercare only | $0.42 | $0.68 | $3.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.45 Typical High $2.09 | Professional | 56 · Pre-op care only | $0.28 | $0.45 | $2.09 |
Where Iowa sits
The same service costs 7.4 times more in Wyoming than in Kansas. 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· 33rd of 51
$2.95
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.