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 $7.94 Median $7.94 Typical High $7.94 | Facility | None | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier None Typical Low $7.59 Median $7.76 Typical High $7.94 | Professional | None | $7.59 | $7.76 | $7.94 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
Cigna Setting Professional Modifier None Typical Low $7.59 Median $7.76 Typical High $9.55 | Professional | None | $7.59 | $7.76 | $9.55 |
Hally Health Setting Professional Modifier None Typical Low $6.03 Median $7.59 Typical High $7.76 | Professional | None | $6.03 | $7.59 | $7.76 |
Medica Setting Facility Modifier None Typical Low $7.41 Median $7.94 Typical High $12.88 | Facility | None | $7.41 | $7.94 | $12.88 |
Medica Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $9.77 | Professional | None | $7.59 | $7.59 | $9.77 |
Midlands Setting Professional Modifier None Typical Low $7.76 Median $9.77 Typical High $9.77 | Professional | None | $7.76 | $9.77 | $9.77 |
United Setting Facility Modifier None Typical Low $7.41 Median $7.41 Typical High $19.05 | Facility | None | $7.41 | $7.41 | $19.05 |
United Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $7.94 | Professional | None | $7.59 | $7.59 | $7.94 |
Wellmark Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | None | $7.59 | $7.59 | $7.59 |
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 $3.98 Median $3.98 Typical High $3.98 | Facility | 52 · Reduced service | $3.98 | $3.98 | $3.98 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.58 Median $1.58 Typical High $1.58 | Facility | 53 · Discontinued | $1.58 | $1.58 | $1.58 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.20 Median $1.20 Typical High $1.20 | Facility | 55 · Aftercare only | $1.20 | $1.20 | $1.20 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.79 Median $0.79 Typical High $0.79 | Facility | 56 · Pre-op care only | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.80 Median $3.89 Typical High $3.98 | Professional | 52 · Reduced service | $3.80 | $3.89 | $3.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.51 Median $1.55 Typical High $1.58 | Professional | 53 · Discontinued | $1.51 | $1.55 | $1.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.12 Median $1.17 Typical High $1.20 | Professional | 55 · Aftercare only | $1.12 | $1.17 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.76 Median $0.78 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.76 | $0.78 | $0.79 |
Where Iowa sits
The same service costs 1.8 times more in Alaska than in North Dakota. 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· 18th of 51
$7.59
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.