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 $1.51 Median $1.51 Typical High $1.51 | Facility | None | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier None Typical Low $1.48 Median $1.51 Typical High $1.51 | Professional | None | $1.48 | $1.51 | $1.51 |
Cigna Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Facility | None | $1.51 | $1.51 | $1.51 |
Cigna Setting Professional Modifier None Typical Low $1.51 Median $1.66 Typical High $1.86 | Professional | None | $1.51 | $1.66 | $1.86 |
Hally Health Setting Professional Modifier None Typical Low $1.12 Median $1.51 Typical High $2.45 | Professional | None | $1.12 | $1.51 | $2.45 |
Medica Setting Facility Modifier None Typical Low $1.51 Median $1.78 Typical High $1.95 | Facility | None | $1.51 | $1.78 | $1.95 |
Medica Setting Professional Modifier None Typical Low $1.51 Median $1.58 Typical High $3.31 | Professional | None | $1.51 | $1.58 | $3.31 |
Midlands Setting Professional Modifier None Typical Low $1.66 Median $2.00 Typical High $2.00 | Professional | None | $1.66 | $2.00 | $2.00 |
Midlands Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Facility | None | $1.51 | $1.51 | $1.51 |
United Setting Facility Modifier None Typical Low $1.48 Median $1.48 Typical High $1.48 | Facility | None | $1.48 | $1.48 | $1.48 |
United Setting Professional Modifier None Typical Low $1.51 Median $1.51 Typical High $1.62 | Professional | None | $1.51 | $1.51 | $1.62 |
Wellmark Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Facility | None | $1.51 | $1.51 | $1.51 |
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 $0.78 Median $0.78 Typical High $0.78 | Facility | 52 · Reduced service | $0.78 | $0.78 | $0.78 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.31 Median $0.31 Typical High $0.31 | Facility | 53 · Discontinued | $0.31 | $0.31 | $0.31 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.23 Median $0.23 Typical High $0.23 | Facility | 55 · Aftercare only | $0.23 | $0.23 | $0.23 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.15 | Facility | 56 · Pre-op care only | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.76 Median $0.78 Typical High $0.78 | Professional | 52 · Reduced service | $0.76 | $0.78 | $0.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.30 Median $0.31 Typical High $0.31 | Professional | 53 · Discontinued | $0.30 | $0.31 | $0.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.22 Median $0.23 Typical High $0.23 | Professional | 55 · Aftercare only | $0.22 | $0.23 | $0.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.15 | $0.15 | $0.15 |
Where Iowa sits
The same service costs 1.5 times more in Alaska than in Alabama. 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· 22nd of 51
$1.51
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.