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 $1.32 Median $1.48 Typical High $2.00 | Facility | None | $1.32 | $1.48 | $2.00 |
Aetna Setting Professional Modifier None Typical Low $1.32 Median $1.48 Typical High $1.48 | Professional | None | $1.32 | $1.48 | $1.48 |
Cigna Setting Facility Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Facility | None | $1.29 | $1.29 | $1.29 |
Cigna Setting Professional Modifier None Typical Low $1.35 Median $1.48 Typical High $1.70 | Professional | None | $1.35 | $1.48 | $1.70 |
Hally Health Setting Professional Modifier None Typical Low $1.29 Median $1.29 Typical High $2.75 | Professional | None | $1.29 | $1.29 | $2.75 |
Medica Setting Facility Modifier None Typical Low $1.26 Median $1.51 Typical High $1.66 | Facility | None | $1.26 | $1.51 | $1.66 |
Medica Setting Professional Modifier None Typical Low $1.17 Median $1.29 Typical High $2.69 | Professional | None | $1.17 | $1.29 | $2.69 |
Midlands Setting Professional Modifier None Typical Low $1.48 Median $1.74 Typical High $1.74 | Professional | None | $1.48 | $1.74 | $1.74 |
Midlands Setting Facility Modifier None Typical Low $1.29 Median $1.29 Typical High $1.29 | Facility | None | $1.29 | $1.29 | $1.29 |
United Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Facility | None | $1.32 | $1.32 | $1.32 |
United Setting Professional Modifier None Typical Low $1.32 Median $1.32 Typical High $1.41 | Professional | None | $1.32 | $1.32 | $1.41 |
Wellmark Setting Facility Modifier None Typical Low $1.32 Median $1.32 Typical High $1.32 | Facility | None | $1.32 | $1.32 | $1.32 |
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 $0.76 Typical High $1.00 | Facility | 52 · Reduced service | $0.68 | $0.76 | $1.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.27 Median $0.30 Typical High $0.40 | Facility | 53 · Discontinued | $0.27 | $0.30 | $0.40 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.20 Median $0.22 Typical High $0.30 | Facility | 55 · Aftercare only | $0.20 | $0.22 | $0.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.15 Typical High $0.20 | Facility | 56 · Pre-op care only | $0.13 | $0.15 | $0.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.68 Median $0.76 Typical High $0.76 | Professional | 52 · Reduced service | $0.68 | $0.76 | $0.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.27 Median $0.30 Typical High $0.30 | Professional | 53 · Discontinued | $0.27 | $0.30 | $0.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.20 Median $0.22 Typical High $0.22 | Professional | 55 · Aftercare only | $0.20 | $0.22 | $0.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.15 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.13 | $0.15 | $0.15 |
Where Iowa sits
The same service costs 1.5 times more in Alaska than in Virginia. 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· 49th of 51
$1.32
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.