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 $0.45 Median $0.45 Typical High $1.78 | Facility | None | $0.45 | $0.45 | $1.78 |
Aetna Setting Professional Modifier None Typical Low $0.45 Median $0.45 Typical High $0.48 | Professional | None | $0.45 | $0.45 | $0.48 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $0.93 Typical High $7.08 | Professional | None | $0.76 | $0.93 | $7.08 |
Hally Health Setting Professional Modifier None Typical Low $19.95 Median $24.55 Typical High $28.18 | Professional | None | $19.95 | $24.55 | $28.18 |
Medica Setting Facility Modifier None Typical Low $0.10 Median $5.50 Typical High $6.03 | Facility | None | $0.10 | $5.50 | $6.03 |
Medica Setting Professional Modifier None Typical Low $1.82 Median $4.57 Typical High $9.33 | Professional | None | $1.82 | $4.57 | $9.33 |
Midlands Setting Professional Modifier None Typical Low $6.03 Median $7.08 Typical High $7.08 | Professional | None | $6.03 | $7.08 | $7.08 |
United Setting Professional Modifier None Typical Low $1.86 Median $4.68 Typical High $6.46 | Professional | None | $1.86 | $4.68 | $6.46 |
4 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 Professional Modifier 52 · Reduced service Typical Low $0.23 Median $0.23 Typical High $0.24 | Professional | 52 · Reduced service | $0.23 | $0.23 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.10 | Professional | 53 · Discontinued | $0.09 | $0.09 | $0.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Where Iowa sits
The same service costs 58.9 times more in Montana than in Hawaii. 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· 5th of 51
$4.68
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.