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 $2.34 Median $2.34 Typical High $4.17 | Facility | None | $2.34 | $2.34 | $4.17 |
Aetna Setting Professional Modifier None Typical Low $1.86 Median $1.86 Typical High $2.34 | Professional | None | $1.86 | $1.86 | $2.34 |
Cigna Setting Professional Modifier None Typical Low $1.78 Median $1.95 Typical High $2.00 | Professional | None | $1.78 | $1.95 | $2.00 |
Hally Health Setting Professional Modifier None Typical Low $1.32 Median $1.70 Typical High $7.94 | Professional | None | $1.32 | $1.70 | $7.94 |
Medica Setting Facility Modifier None Typical Low $0.95 Median $2.34 Typical High $6.61 | Facility | None | $0.95 | $2.34 | $6.61 |
Medica Setting Professional Modifier None Typical Low $1.51 Median $1.70 Typical High $2.40 | Professional | None | $1.51 | $1.70 | $2.40 |
Midlands Setting Professional Modifier None Typical Low $0.98 Median $1.95 Typical High $2.00 | Professional | None | $0.98 | $1.95 | $2.00 |
Midlands Setting Professional Modifier None Typical Low $0.98 Median $2.09 Typical High $8.91 | Professional | None | $0.98 | $2.09 | $8.91 |
Oscar Health Setting Professional Modifier None Typical Low $1.45 Median $2.40 Typical High $3.55 | Professional | None | $1.45 | $2.40 | $3.55 |
United Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.74 | Professional | None | $1.66 | $1.66 | $1.74 |
Wellmark Setting Facility Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Facility | None | $1.66 | $1.66 | $1.66 |
Wellmark Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $1.66 | Professional | None | $1.66 | $1.66 | $1.66 |
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 $0.93 Median $1.17 Typical High $1.26 | Facility | 52 · Reduced service | $0.93 | $1.17 | $1.26 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $0.37 Median $0.47 Typical High $0.50 | Facility | 53 · Discontinued | $0.37 | $0.47 | $0.50 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $0.28 Median $0.35 Typical High $0.37 | Facility | 55 · Aftercare only | $0.28 | $0.35 | $0.37 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.24 Typical High $0.25 | Facility | 56 · Pre-op care only | $0.19 | $0.24 | $0.25 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $0.93 Median $0.93 Typical High $1.17 | Professional | 52 · Reduced service | $0.93 | $0.93 | $1.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.37 Median $0.37 Typical High $0.47 | Professional | 53 · Discontinued | $0.37 | $0.37 | $0.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.28 Median $0.28 Typical High $0.35 | Professional | 55 · Aftercare only | $0.28 | $0.28 | $0.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.19 Median $0.19 Typical High $0.24 | Professional | 56 · Pre-op care only | $0.19 | $0.19 | $0.24 |
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· 46th of 51
$1.78
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.