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 $1.23 Median $1.23 Typical High $2.04 | Facility | None | $1.23 | $1.23 | $2.04 |
Aetna Setting Professional Modifier None Typical Low $1.23 Median $1.41 Typical High $1.45 | Professional | None | $1.23 | $1.41 | $1.45 |
Cigna Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Facility | None | $1.41 | $1.41 | $1.41 |
Cigna Setting Professional Modifier None Typical Low $1.45 Median $1.51 Typical High $1.78 | Professional | None | $1.45 | $1.51 | $1.78 |
Hally Health Setting Professional Modifier None Typical Low $1.26 Median $1.41 Typical High $2.69 | Professional | None | $1.26 | $1.41 | $2.69 |
Medica Setting Facility Modifier None Typical Low $1.20 Median $1.51 Typical High $1.74 | Facility | None | $1.20 | $1.51 | $1.74 |
Medica Setting Professional Modifier None Typical Low $1.35 Median $1.38 Typical High $2.40 | Professional | None | $1.35 | $1.38 | $2.40 |
Midlands Setting Professional Modifier None Typical Low $1.41 Median $1.51 Typical High $1.78 | Professional | None | $1.41 | $1.51 | $1.78 |
Midlands Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Facility | None | $1.41 | $1.41 | $1.41 |
United Setting Facility Modifier None Typical Low $1.41 Median $1.41 Typical High $1.41 | Facility | None | $1.41 | $1.41 | $1.41 |
United Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.45 | Professional | None | $1.38 | $1.38 | $1.45 |
Wellmark Setting Facility Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Facility | None | $1.38 | $1.38 | $1.38 |
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 $0.62 Median $0.62 Typical High $1.02 | Facility | 52 · Reduced service | $0.62 | $0.62 | $1.02 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.25 Median $0.25 Typical High $0.41 | Facility | 53 · Discontinued | $0.25 | $0.25 | $0.41 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.18 Median $0.18 Typical High $0.31 | Facility | 55 · Aftercare only | $0.18 | $0.18 | $0.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.12 Typical High $0.21 | Facility | 56 · Pre-op care only | $0.12 | $0.12 | $0.21 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.62 Median $0.71 Typical High $0.72 | Professional | 52 · Reduced service | $0.62 | $0.71 | $0.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.25 Median $0.28 Typical High $0.28 | Professional | 53 · Discontinued | $0.25 | $0.28 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.18 Median $0.21 Typical High $0.22 | Professional | 55 · Aftercare only | $0.18 | $0.21 | $0.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.12 Median $0.14 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.12 | $0.14 | $0.15 |
Where Iowa sits
The same service costs 1.7 times more in Arizona than in Rhode Island. 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· 50th 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.