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 $1.62 Median $1.62 Typical High $2.63 | Facility | None | $1.62 | $1.62 | $2.63 |
Aetna Setting Professional Modifier None Typical Low $1.62 Median $1.74 Typical High $1.82 | Professional | None | $1.62 | $1.74 | $1.82 |
Cigna Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Facility | None | $1.70 | $1.70 | $1.70 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $2.00 Typical High $2.19 | Professional | None | $1.78 | $2.00 | $2.19 |
Hally Health Setting Professional Modifier None Typical Low $1.35 Median $1.70 Typical High $3.55 | Professional | None | $1.35 | $1.70 | $3.55 |
Medica Setting Facility Modifier None Typical Low $1.58 Median $1.95 Typical High $2.14 | Facility | None | $1.58 | $1.95 | $2.14 |
Medica Setting Professional Modifier None Typical Low $1.58 Median $1.62 Typical High $3.72 | Professional | None | $1.58 | $1.62 | $3.72 |
Midlands Setting Professional Modifier None Typical Low $2.00 Median $2.24 Typical High $2.24 | Professional | None | $2.00 | $2.24 | $2.24 |
Midlands Setting Facility Modifier None Typical Low $1.70 Median $1.70 Typical High $1.70 | Facility | None | $1.70 | $1.70 | $1.70 |
United Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Facility | None | $1.74 | $1.74 | $1.74 |
United Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $1.86 | Professional | None | $1.74 | $1.74 | $1.86 |
Wellmark Setting Facility Modifier None Typical Low $1.74 Median $1.74 Typical High $1.74 | Facility | None | $1.74 | $1.74 | $1.74 |
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 $0.81 Median $0.81 Typical High $1.32 | Facility | 52 · Reduced service | $0.81 | $0.81 | $1.32 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.32 Median $0.32 Typical High $0.52 | Facility | 53 · Discontinued | $0.32 | $0.32 | $0.52 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.24 Median $0.24 Typical High $0.39 | Facility | 55 · Aftercare only | $0.24 | $0.24 | $0.39 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.16 Typical High $0.26 | Facility | 56 · Pre-op care only | $0.16 | $0.16 | $0.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.81 Median $0.85 Typical High $0.91 | Professional | 52 · Reduced service | $0.81 | $0.85 | $0.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.32 Median $0.34 Typical High $0.37 | Professional | 53 · Discontinued | $0.32 | $0.34 | $0.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.24 Median $0.26 Typical High $0.27 | Professional | 55 · Aftercare only | $0.24 | $0.26 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.16 Median $0.17 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.16 | $0.17 | $0.18 |
Where Iowa sits
The same service costs 1.8 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· 31st of 51
$1.74
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.