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 $8.71 Median $41.69 Typical High $41.69 | Facility | None | $8.71 | $41.69 | $41.69 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $41.69 | Professional | None | $8.13 | $8.13 | $41.69 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $10.47 Typical High $31.62 | Professional | None | $8.13 | $10.47 | $31.62 |
Hally Health Setting Professional Modifier None Typical Low $10.72 Median $66.07 Typical High $77.62 | Professional | None | $10.72 | $66.07 | $77.62 |
Medica Setting Facility Modifier None Typical Low $9.77 Median $14.79 Typical High $41.69 | Facility | None | $9.77 | $14.79 | $41.69 |
Medica Setting Professional Modifier None Typical Low $9.77 Median $11.48 Typical High $30.90 | Professional | None | $9.77 | $11.48 | $30.90 |
Midlands Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $31.62 | Professional | None | $10.47 | $10.47 | $31.62 |
Midlands Setting Professional Modifier None Typical Low $12.30 Median $31.62 Typical High $43.65 | Professional | None | $12.30 | $31.62 | $43.65 |
Oscar Health Setting Professional Modifier None Typical Low $7.94 Median $13.18 Typical High $18.62 | Professional | None | $7.94 | $13.18 | $18.62 |
United Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $8.71 Median $9.33 Typical High $10.47 | Professional | None | $8.71 | $9.33 | $10.47 |
Wellmark Setting Facility Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Facility | None | $9.55 | $9.55 | $9.55 |
Wellmark Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
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 $4.37 Median $20.89 Typical High $20.89 | Facility | 52 · Reduced service | $4.37 | $20.89 | $20.89 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.74 Median $8.32 Typical High $8.32 | Facility | 53 · Discontinued | $1.74 | $8.32 | $8.32 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.32 Median $6.31 Typical High $6.31 | Facility | 55 · Aftercare only | $1.32 | $6.31 | $6.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.87 Median $4.17 Typical High $4.17 | Facility | 56 · Pre-op care only | $0.87 | $4.17 | $4.17 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.07 Median $4.07 Typical High $20.89 | Professional | 52 · Reduced service | $4.07 | $4.07 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $8.32 | Professional | 53 · Discontinued | $1.62 | $1.62 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $6.31 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $4.17 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $4.17 |
Where Iowa sits
The same service costs 1.9 times more in Wyoming than in Georgia. 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· 7th of 51
$10.47
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.