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 $1.78 Median $3.89 Typical High $3.89 | Facility | None | $1.78 | $3.89 | $3.89 |
Aetna Setting Professional Modifier None Typical Low $1.58 Median $2.34 Typical High $3.89 | Professional | None | $1.58 | $2.34 | $3.89 |
Cigna Setting Professional Modifier None Typical Low $1.62 Median $2.04 Typical High $3.02 | Professional | None | $1.62 | $2.04 | $3.02 |
Hally Health Setting Professional Modifier None Typical Low $1.82 Median $2.51 Typical High $14.79 | Professional | None | $1.82 | $2.51 | $14.79 |
Medica Setting Facility Modifier None Typical Low $2.09 Median $3.39 Typical High $16.22 | Facility | None | $2.09 | $3.39 | $16.22 |
Medica Setting Professional Modifier None Typical Low $1.78 Median $1.91 Typical High $6.31 | Professional | None | $1.78 | $1.91 | $6.31 |
Midlands Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $3.47 | Professional | None | $2.34 | $2.34 | $3.47 |
United Setting Professional Modifier None Typical Low $1.55 Median $1.55 Typical High $1.70 | Professional | None | $1.55 | $1.55 | $1.70 |
Wellmark Setting Facility Modifier None Typical Low $1.55 Median $1.55 Typical High $1.55 | Facility | None | $1.55 | $1.55 | $1.55 |
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 $0.79 Median $1.95 Typical High $1.95 | Facility | 52 · Reduced service | $0.79 | $1.95 | $1.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.32 Median $0.78 Typical High $0.78 | Facility | 53 · Discontinued | $0.32 | $0.78 | $0.78 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.24 Median $0.58 Typical High $0.58 | Facility | 55 · Aftercare only | $0.24 | $0.58 | $0.58 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.39 Typical High $0.39 | Facility | 56 · Pre-op care only | $0.16 | $0.39 | $0.39 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.79 Median $1.17 Typical High $1.95 | Professional | 52 · Reduced service | $0.79 | $1.17 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.47 Typical High $0.78 | Professional | 53 · Discontinued | $0.32 | $0.47 | $0.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.35 Typical High $0.58 | Professional | 55 · Aftercare only | $0.24 | $0.35 | $0.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.23 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.16 | $0.23 | $0.39 |
Where Iowa sits
The same service costs 3.6 times more in Texas than in Rhode Island. 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· 26th of 51
$1.78
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.