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 $3.09 Median $5.37 Typical High $5.37 | Facility | None | $3.09 | $5.37 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $2.04 Median $2.04 Typical High $5.37 | Professional | None | $2.04 | $2.04 | $5.37 |
Cigna Setting Professional Modifier None Typical Low $2.04 Median $2.09 Typical High $2.57 | Professional | None | $2.04 | $2.09 | $2.57 |
Hally Health Setting Professional Modifier None Typical Low $2.00 Median $2.63 Typical High $9.33 | Professional | None | $2.00 | $2.63 | $9.33 |
Medica Setting Facility Modifier None Typical Low $2.00 Median $2.88 Typical High $5.37 | Facility | None | $2.00 | $2.88 | $5.37 |
Medica Setting Professional Modifier None Typical Low $1.74 Median $2.34 Typical High $3.39 | Professional | None | $1.74 | $2.34 | $3.39 |
Midlands Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $3.47 | Professional | None | $2.45 | $2.45 | $3.47 |
Midlands Setting Professional Modifier None Typical Low $3.02 Median $3.39 Typical High $3.47 | Professional | None | $3.02 | $3.39 | $3.47 |
Oscar Health Setting Professional Modifier None Typical Low $2.09 Median $3.47 Typical High $4.37 | Professional | None | $2.09 | $3.47 | $4.37 |
United Setting Professional Modifier None Typical Low $2.04 Median $2.19 Typical High $2.63 | Professional | None | $2.04 | $2.19 | $2.63 |
Wellmark Setting Facility Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Facility | None | $2.24 | $2.24 | $2.24 |
Wellmark Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.24 | Professional | None | $2.24 | $2.24 | $2.24 |
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 $1.02 Median $2.69 Typical High $2.69 | Facility | 52 · Reduced service | $1.02 | $2.69 | $2.69 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.41 Median $1.07 Typical High $1.07 | Facility | 53 · Discontinued | $0.41 | $1.07 | $1.07 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.31 Median $0.81 Typical High $0.81 | Facility | 55 · Aftercare only | $0.31 | $0.81 | $0.81 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.54 Typical High $0.54 | Facility | 56 · Pre-op care only | $0.21 | $0.54 | $0.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.00 Median $1.00 Typical High $2.69 | Professional | 52 · Reduced service | $1.00 | $1.00 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.40 Median $0.40 Typical High $1.07 | Professional | 53 · Discontinued | $0.40 | $0.40 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.30 Median $0.30 Typical High $0.81 | Professional | 55 · Aftercare only | $0.30 | $0.30 | $0.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.20 Median $0.20 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.20 | $0.20 | $0.54 |
Where Iowa sits
The same service costs 2.1 times more in Wyoming than in Delaware. 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· 12th of 51
$2.24
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.