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 $6.03 Median $7.94 Typical High $8.13 | Professional | None | $6.03 | $7.94 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $8.91 Median $9.12 Typical High $11.75 | Professional | None | $8.91 | $9.12 | $11.75 |
Hally Health Setting Professional Modifier None Typical Low $7.76 Median $8.51 Typical High $27.54 | Professional | None | $7.76 | $8.51 | $27.54 |
Medica Setting Facility Modifier None Typical Low $8.91 Median $10.47 Typical High $15.85 | Facility | None | $8.91 | $10.47 | $15.85 |
Medica Setting Professional Modifier None Typical Low $3.98 Median $6.92 Typical High $107.15 | Professional | None | $3.98 | $6.92 | $107.15 |
Midlands Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $10.72 | Professional | None | $9.12 | $9.12 | $10.72 |
Midlands Setting Professional Modifier None Typical Low $9.55 Median $13.49 Typical High $17.78 | Professional | None | $9.55 | $13.49 | $17.78 |
Oscar Health Setting Professional Modifier None Typical Low $8.32 Median $11.48 Typical High $17.38 | Professional | None | $8.32 | $11.48 | $17.38 |
United Setting Professional Modifier None Typical Low $3.47 Median $4.07 Typical High $7.08 | Professional | None | $3.47 | $4.07 | $7.08 |
Wellmark Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $6.61 | Professional | None | $6.61 | $6.61 | $6.61 |
5 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 $3.24 Median $3.98 Typical High $4.07 | Professional | 52 · Reduced service | $3.24 | $3.98 | $4.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.29 Median $1.58 Typical High $1.62 | Professional | 53 · Discontinued | $1.29 | $1.58 | $1.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.79 Median $5.89 Typical High $6.03 | Professional | 54 · Surgery only | $4.79 | $5.89 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.95 Median $1.20 Typical High $1.20 | Professional | 55 · Aftercare only | $0.95 | $1.20 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $0.79 Typical High $0.81 | Professional | 56 · Pre-op care only | $0.65 | $0.79 | $0.81 |
Where Iowa sits
The same service costs 3.2 times more in Rhode Island than in New York. 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· 7th of 51
$8.13
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.