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 $4.17 Median $4.17 Typical High $4.17 | Facility | None | $4.17 | $4.17 | $4.17 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $4.17 Typical High $4.27 | Professional | None | $3.24 | $4.17 | $4.27 |
Cigna Setting Professional Modifier None Typical Low $4.68 Median $4.79 Typical High $6.03 | Professional | None | $4.68 | $4.79 | $6.03 |
Hally Health Setting Professional Modifier None Typical Low $4.07 Median $4.47 Typical High $16.60 | Professional | None | $4.07 | $4.47 | $16.60 |
Medica Setting Facility Modifier None Typical Low $4.68 Median $5.50 Typical High $8.91 | Facility | None | $4.68 | $5.50 | $8.91 |
Medica Setting Professional Modifier None Typical Low $2.09 Median $3.63 Typical High $69.18 | Professional | None | $2.09 | $3.63 | $69.18 |
Midlands Setting Professional Modifier None Typical Low $4.79 Median $4.79 Typical High $5.62 | Professional | None | $4.79 | $4.79 | $5.62 |
Midlands Setting Professional Modifier None Typical Low $5.01 Median $7.08 Typical High $9.77 | Professional | None | $5.01 | $7.08 | $9.77 |
Oscar Health Setting Professional Modifier None Typical Low $4.27 Median $6.03 Typical High $9.12 | Professional | None | $4.27 | $6.03 | $9.12 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.09 Typical High $3.72 | Professional | None | $1.78 | $2.09 | $3.72 |
Wellmark Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $3.47 | Professional | None | $3.47 | $3.47 | $3.47 |
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 $1.62 Median $2.09 Typical High $2.14 | Professional | 52 · Reduced service | $1.62 | $2.09 | $2.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.83 Typical High $0.85 | Professional | 53 · Discontinued | $0.65 | $0.83 | $0.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.40 Median $3.09 Typical High $3.16 | Professional | 54 · Surgery only | $2.40 | $3.09 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.48 Median $0.62 Typical High $0.63 | Professional | 55 · Aftercare only | $0.48 | $0.62 | $0.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.32 Median $0.42 Typical High $0.42 | Professional | 56 · Pre-op care only | $0.32 | $0.42 | $0.42 |
Where Iowa sits
The same service costs 4.0 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· 6th of 51
$4.27
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.