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 $4.17 Median $5.50 Typical High $6.17 | Facility | None | $4.17 | $5.50 | $6.17 |
Aetna Setting Professional Modifier None Typical Low $4.17 Median $5.50 Typical High $5.50 | Professional | None | $4.17 | $5.50 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $3.89 Median $4.27 Typical High $5.37 | Professional | None | $3.89 | $4.27 | $5.37 |
Hally Health Setting Professional Modifier None Typical Low $2.88 Median $4.07 Typical High $4.79 | Professional | None | $2.88 | $4.07 | $4.79 |
Medica Setting Facility Modifier None Typical Low $3.02 Median $4.79 Typical High $5.37 | Facility | None | $3.02 | $4.79 | $5.37 |
Medica Setting Professional Modifier None Typical Low $3.80 Median $4.07 Typical High $7.94 | Professional | None | $3.80 | $4.07 | $7.94 |
Midlands Setting Professional Modifier None Typical Low $3.89 Median $5.25 Typical High $5.25 | Professional | None | $3.89 | $5.25 | $5.25 |
United Setting Facility Modifier None Typical Low $4.17 Median $4.17 Typical High $4.17 | Facility | None | $4.17 | $4.17 | $4.17 |
United Setting Professional Modifier None Typical Low $4.07 Median $4.07 Typical High $4.37 | Professional | None | $4.07 | $4.07 | $4.37 |
Wellmark Setting Facility Modifier None Typical Low $4.07 Median $4.07 Typical High $4.07 | Facility | None | $4.07 | $4.07 | $4.07 |
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 $2.09 Median $2.75 Typical High $3.09 | Facility | 52 · Reduced service | $2.09 | $2.75 | $3.09 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.83 Median $1.10 Typical High $1.23 | Facility | 53 · Discontinued | $0.83 | $1.10 | $1.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.63 Median $0.83 Typical High $0.93 | Facility | 55 · Aftercare only | $0.63 | $0.83 | $0.93 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.55 Typical High $0.62 | Facility | 56 · Pre-op care only | $0.42 | $0.55 | $0.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $2.09 Median $2.75 Typical High $2.75 | Professional | 52 · Reduced service | $2.09 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.83 Median $1.10 Typical High $1.10 | Professional | 53 · Discontinued | $0.83 | $1.10 | $1.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.63 Median $0.83 Typical High $0.83 | Professional | 55 · Aftercare only | $0.63 | $0.83 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.42 Median $0.55 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.42 | $0.55 | $0.55 |
Where Iowa sits
The same service costs 1.6 times more in Arizona than in Maryland. 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
$4.07
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.