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 $0.59 Median $0.59 Typical High $0.59 | Facility | None | $0.59 | $0.59 | $0.59 |
Aetna Setting Professional Modifier None Typical Low $0.32 Median $0.59 Typical High $0.63 | Professional | None | $0.32 | $0.59 | $0.63 |
Cigna Setting Facility Modifier None Typical Low $0.42 Median $0.85 Typical High $0.85 | Facility | None | $0.42 | $0.85 | $0.85 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $1.00 Typical High $1.00 | Professional | None | $0.76 | $1.00 | $1.00 |
Hally Health Setting Professional Modifier None Typical Low $0.72 Median $0.87 Typical High $1.78 | Professional | None | $0.72 | $0.87 | $1.78 |
Medica Setting Facility Modifier None Typical Low $0.72 Median $0.95 Typical High $79.43 | Facility | None | $0.72 | $0.95 | $79.43 |
Medica Setting Professional Modifier None Typical Low $0.37 Median $0.65 Typical High $1.95 | Professional | None | $0.37 | $0.65 | $1.95 |
Midlands Setting Professional Modifier None Typical Low $0.85 Median $1.00 Typical High $1.00 | Professional | None | $0.85 | $1.00 | $1.00 |
Midlands Setting Facility Modifier None Typical Low $0.85 Median $0.85 Typical High $0.85 | Facility | None | $0.85 | $0.85 | $0.85 |
Midlands Setting Professional Modifier None Typical Low $0.76 Median $1.23 Typical High $1.23 | Professional | None | $0.76 | $1.23 | $1.23 |
United Setting Facility Modifier None Typical Low $1.10 Median $1.10 Typical High $2.14 | Facility | None | $1.10 | $1.10 | $2.14 |
United Setting Professional Modifier None Typical Low $0.35 Median $0.37 Typical High $0.66 | Professional | None | $0.35 | $0.37 | $0.66 |
Wellmark Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.76 | Professional | None | $0.76 | $0.76 | $0.76 |
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 $0.16 Median $0.30 Typical High $0.32 | Professional | 52 · Reduced service | $0.16 | $0.30 | $0.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.12 Typical High $0.13 | Professional | 53 · Discontinued | $0.06 | $0.12 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.05 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.03 | $0.06 | $0.06 |
Where Iowa sits
The same service costs 2.3 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· 4th of 51
$0.76
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.