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 $4.79 Median $25.70 Typical High $25.70 | Facility | None | $4.79 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $4.79 Typical High $25.70 | Professional | None | $3.24 | $4.79 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $3.80 Typical High $4.17 | Professional | None | $3.31 | $3.80 | $4.17 |
Hally Health Setting Professional Modifier None Typical Low $1.26 Median $2.75 Typical High $11.22 | Professional | None | $1.26 | $2.75 | $11.22 |
Medica Setting Facility Modifier None Typical Low $2.00 Median $2.95 Typical High $6.31 | Facility | None | $2.00 | $2.95 | $6.31 |
Medica Setting Professional Modifier None Typical Low $2.51 Median $2.82 Typical High $8.71 | Professional | None | $2.51 | $2.82 | $8.71 |
Midlands Setting Professional Modifier None Typical Low $3.63 Median $3.63 Typical High $3.89 | Professional | None | $3.63 | $3.63 | $3.89 |
United Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.47 | Professional | None | $3.16 | $3.16 | $3.47 |
Wellmark Setting Facility Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Facility | None | $3.16 | $3.16 | $3.16 |
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 $1.62 Median $12.88 Typical High $12.88 | Facility | 52 · Reduced service | $1.62 | $12.88 | $12.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.65 Median $5.13 Typical High $5.13 | Facility | 53 · Discontinued | $0.65 | $5.13 | $5.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.49 Median $3.89 Typical High $3.89 | Facility | 55 · Aftercare only | $0.49 | $3.89 | $3.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.33 Median $2.57 Typical High $2.57 | Facility | 56 · Pre-op care only | $0.33 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.62 Median $2.40 Typical High $12.88 | Professional | 52 · Reduced service | $1.62 | $2.40 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.95 Typical High $5.13 | Professional | 53 · Discontinued | $0.65 | $0.95 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.72 Typical High $3.89 | Professional | 55 · Aftercare only | $0.49 | $0.72 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.48 Typical High $2.57 | Professional | 56 · Pre-op care only | $0.33 | $0.48 | $2.57 |
Where Iowa sits
The same service costs 7.9 times more in Wyoming than in Louisiana. 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· 48th of 51
$3.16
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.