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 $0.02 Median $0.12 Typical High $0.12 | Facility | None | $0.02 | $0.12 | $0.12 |
Aetna Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.12 | Professional | None | $0.02 | $0.02 | $0.12 |
Cigna Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.04 | Professional | None | $0.02 | $0.02 | $0.04 |
Hally Health Setting Professional Modifier None Typical Low $1.12 Median $1.91 Typical High $3.02 | Professional | None | $1.12 | $1.91 | $3.02 |
Medica Setting Facility Modifier None Typical Low $0.02 Median $0.08 Typical High $0.12 | Facility | None | $0.02 | $0.08 | $0.12 |
Medica Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.06 | Professional | None | $0.02 | $0.02 | $0.06 |
Midlands Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
Midlands Setting Professional Modifier None Typical Low $0.04 Median $0.06 Typical High $0.06 | Professional | None | $0.04 | $0.06 | $0.06 |
Oscar Health Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.03 | Professional | None | $0.02 | $0.02 | $0.03 |
United Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
Wellmark Setting Facility Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Facility | None | $0.02 | $0.02 | $0.02 |
Wellmark Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
6 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 $0.02 Median $0.06 Typical High $0.06 | Facility | 52 · Reduced service | $0.02 | $0.06 | $0.06 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.02 | Facility | 53 · Discontinued | $0.02 | $0.02 | $0.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Facility | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 52 · Reduced service | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 53 · Discontinued | $0.02 | $0.02 | $0.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Where Iowa sits
The same service costs 6.0 times more in Wyoming than in Massachusetts. 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· 32nd of 51
$0.02
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.