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 $2.95 Median $3.55 Typical High $4.07 | Facility | None | $2.95 | $3.55 | $4.07 |
Aetna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $4.07 | Professional | None | $2.95 | $2.95 | $4.07 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $3.24 Typical High $3.47 | Professional | None | $2.95 | $3.24 | $3.47 |
Hally Health Setting Professional Modifier None Typical Low $2.82 Median $3.24 Typical High $10.23 | Professional | None | $2.82 | $3.24 | $10.23 |
Medica Setting Facility Modifier None Typical Low $2.95 Median $3.89 Typical High $4.07 | Facility | None | $2.95 | $3.89 | $4.07 |
Medica Setting Professional Modifier None Typical Low $2.24 Median $2.69 Typical High $3.80 | Professional | None | $2.24 | $2.69 | $3.80 |
Midlands Setting Professional Modifier None Typical Low $3.02 Median $3.24 Typical High $3.39 | Professional | None | $3.02 | $3.24 | $3.39 |
Midlands Setting Professional Modifier None Typical Low $3.02 Median $3.39 Typical High $5.25 | Professional | None | $3.02 | $3.39 | $5.25 |
Oscar Health Setting Professional Modifier None Typical Low $2.82 Median $4.57 Typical High $5.75 | Professional | None | $2.82 | $4.57 | $5.75 |
United Setting Professional Modifier None Typical Low $2.69 Median $2.82 Typical High $3.16 | Professional | None | $2.69 | $2.82 | $3.16 |
Wellmark Setting Facility Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Facility | None | $2.95 | $2.95 | $2.95 |
Wellmark Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $2.95 | Professional | None | $2.95 | $2.95 | $2.95 |
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 $1.48 Median $1.78 Typical High $2.04 | Facility | 52 · Reduced service | $1.48 | $1.78 | $2.04 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.59 Median $0.71 Typical High $0.81 | Facility | 53 · Discontinued | $0.59 | $0.71 | $0.81 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.44 Median $0.52 Typical High $0.62 | Facility | 55 · Aftercare only | $0.44 | $0.52 | $0.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.35 Typical High $0.40 | Facility | 56 · Pre-op care only | $0.28 | $0.35 | $0.40 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.48 Median $1.48 Typical High $1.78 | Professional | 52 · Reduced service | $1.48 | $1.48 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.59 Median $0.59 Typical High $0.71 | Professional | 53 · Discontinued | $0.59 | $0.59 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.44 Median $0.44 Typical High $0.52 | Professional | 55 · Aftercare only | $0.44 | $0.44 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.28 Median $0.28 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.28 | $0.28 | $0.35 |
Where Iowa sits
Rates are fairly even across states for this service. 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· 27th of 51
$2.95
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.