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 $3.24 Median $3.55 Typical High $4.90 | Facility | None | $3.24 | $3.55 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.55 Typical High $3.55 | Professional | None | $3.24 | $3.55 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $3.89 Typical High $4.17 | Professional | None | $3.31 | $3.89 | $4.17 |
Hally Health Setting Professional Modifier None Typical Low $1.51 Median $3.24 Typical High $10.96 | Professional | None | $1.51 | $3.24 | $10.96 |
Medica Setting Facility Modifier None Typical Low $3.24 Median $3.89 Typical High $4.57 | Facility | None | $3.24 | $3.89 | $4.57 |
Medica Setting Professional Modifier None Typical Low $3.24 Median $3.31 Typical High $8.32 | Professional | None | $3.24 | $3.31 | $8.32 |
Midlands Setting Professional Modifier None Typical Low $3.98 Median $4.17 Typical High $4.17 | Professional | None | $3.98 | $4.17 | $4.17 |
Midlands Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
United Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
United Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.47 | Professional | None | $3.24 | $3.24 | $3.47 |
Wellmark Setting Facility Modifier None Typical Low $3.24 Median $3.24 Typical High $3.24 | Facility | None | $3.24 | $3.24 | $3.24 |
10 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 $1.78 Typical High $2.45 | Facility | 52 · Reduced service | $1.62 | $1.78 | $2.45 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.65 Median $0.71 Typical High $0.98 | Facility | 53 · Discontinued | $0.65 | $0.71 | $0.98 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $2.45 Median $2.63 Typical High $3.63 | Facility | 54 · Surgery only | $2.45 | $2.63 | $3.63 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.49 Median $0.52 Typical High $0.72 | Facility | 55 · Aftercare only | $0.49 | $0.52 | $0.72 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.35 Typical High $0.49 | Facility | 56 · Pre-op care only | $0.32 | $0.35 | $0.49 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.62 Median $1.78 Typical High $1.78 | Professional | 52 · Reduced service | $1.62 | $1.78 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.71 Typical High $0.71 | Professional | 53 · Discontinued | $0.65 | $0.71 | $0.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.45 Median $2.63 Typical High $2.63 | Professional | 54 · Surgery only | $2.45 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.52 Typical High $0.52 | Professional | 55 · Aftercare only | $0.49 | $0.52 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.35 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.32 | $0.35 | $0.35 |
Where Iowa sits
The same service costs 1.7 times more in Arizona than in North Dakota. 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· 36th of 51
$3.24
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.