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 $1.35 Median $4.47 Typical High $4.47 | Facility | None | $1.35 | $4.47 | $4.47 |
Aetna Setting Professional Modifier None Typical Low $1.35 Median $1.82 Typical High $4.47 | Professional | None | $1.35 | $1.82 | $4.47 |
Cigna Setting Professional Modifier None Typical Low $1.38 Median $1.62 Typical High $1.74 | Professional | None | $1.38 | $1.62 | $1.74 |
Hally Health Setting Professional Modifier None Typical Low $0.81 Median $1.26 Typical High $2.69 | Professional | None | $0.81 | $1.26 | $2.69 |
Medica Setting Facility Modifier None Typical Low $1.00 Median $1.51 Typical High $4.47 | Facility | None | $1.00 | $1.51 | $4.47 |
Medica Setting Professional Modifier None Typical Low $1.17 Median $1.38 Typical High $2.51 | Professional | None | $1.17 | $1.38 | $2.51 |
Midlands Setting Professional Modifier None Typical Low $1.62 Median $1.66 Typical High $1.66 | Professional | None | $1.62 | $1.66 | $1.66 |
United Setting Professional Modifier None Typical Low $1.35 Median $1.35 Typical High $1.45 | Professional | None | $1.35 | $1.35 | $1.45 |
Wellmark Setting Facility Modifier None Typical Low $1.35 Median $1.35 Typical High $1.35 | Facility | None | $1.35 | $1.35 | $1.35 |
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 $0.68 Median $2.24 Typical High $2.24 | Facility | 52 · Reduced service | $0.68 | $2.24 | $2.24 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.27 Median $0.89 Typical High $0.89 | Facility | 53 · Discontinued | $0.27 | $0.89 | $0.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.20 Median $0.66 Typical High $0.66 | Facility | 55 · Aftercare only | $0.20 | $0.66 | $0.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.44 Typical High $0.44 | Facility | 56 · Pre-op care only | $0.14 | $0.44 | $0.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.68 Median $1.02 Typical High $2.24 | Professional | 52 · Reduced service | $0.68 | $1.02 | $2.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.41 Typical High $0.89 | Professional | 53 · Discontinued | $0.27 | $0.41 | $0.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.31 Typical High $0.66 | Professional | 55 · Aftercare only | $0.20 | $0.31 | $0.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.14 Median $0.21 Typical High $0.44 | Professional | 56 · Pre-op care only | $0.14 | $0.21 | $0.44 |
Where Iowa sits
The same service costs 3.2 times more in Wyoming than in Maine. 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· 29th of 51
$1.38
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.