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 $2.29 Median $2.29 Typical High $3.63 | Facility | None | $2.29 | $2.29 | $3.63 |
Aetna Setting Professional Modifier None Typical Low $2.29 Median $2.45 Typical High $2.51 | Professional | None | $2.29 | $2.45 | $2.51 |
Cigna Setting Facility Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Facility | None | $2.40 | $2.40 | $2.40 |
Cigna Setting Professional Modifier None Typical Low $2.45 Median $2.75 Typical High $3.09 | Professional | None | $2.45 | $2.75 | $3.09 |
Hally Health Setting Professional Modifier None Typical Low $2.00 Median $2.40 Typical High $8.91 | Professional | None | $2.00 | $2.40 | $8.91 |
Medica Setting Facility Modifier None Typical Low $2.24 Median $2.69 Typical High $3.24 | Facility | None | $2.24 | $2.69 | $3.24 |
Medica Setting Professional Modifier None Typical Low $2.29 Median $2.45 Typical High $4.47 | Professional | None | $2.29 | $2.45 | $4.47 |
Midlands Setting Professional Modifier None Typical Low $2.75 Median $3.16 Typical High $3.16 | Professional | None | $2.75 | $3.16 | $3.16 |
Midlands Setting Facility Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Facility | None | $2.40 | $2.40 | $2.40 |
United Setting Facility Modifier None Typical Low $2.45 Median $2.45 Typical High $2.45 | Facility | None | $2.45 | $2.45 | $2.45 |
United Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.57 | Professional | None | $2.40 | $2.40 | $2.57 |
Wellmark Setting Facility Modifier None Typical Low $2.40 Median $2.40 Typical High $2.40 | Facility | None | $2.40 | $2.40 | $2.40 |
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 $1.15 Median $1.15 Typical High $1.82 | Facility | 52 · Reduced service | $1.15 | $1.15 | $1.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.46 Median $0.46 Typical High $0.72 | Facility | 53 · Discontinued | $0.46 | $0.46 | $0.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.35 Median $0.35 Typical High $0.55 | Facility | 55 · Aftercare only | $0.35 | $0.35 | $0.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.23 Typical High $0.37 | Facility | 56 · Pre-op care only | $0.23 | $0.23 | $0.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.15 Median $1.23 Typical High $1.26 | Professional | 52 · Reduced service | $1.15 | $1.23 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.46 Median $0.49 Typical High $0.50 | Professional | 53 · Discontinued | $0.46 | $0.49 | $0.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.35 Median $0.37 Typical High $0.38 | Professional | 55 · Aftercare only | $0.35 | $0.37 | $0.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.23 Median $0.25 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.23 | $0.25 | $0.25 |
Where Iowa sits
The same service costs 1.7 times more in Arizona than in Iowa. 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· 51st of 51
$2.40
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.