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 $7.08 Median $7.08 Typical High $7.08 | Facility | None | $7.08 | $7.08 | $7.08 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $7.08 Typical High $7.24 | Professional | None | $5.37 | $7.08 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $7.94 Median $8.13 Typical High $10.23 | Professional | None | $7.94 | $8.13 | $10.23 |
Hally Health Setting Professional Modifier None Typical Low $6.92 Median $7.59 Typical High $21.88 | Professional | None | $6.92 | $7.59 | $21.88 |
Medica Setting Facility Modifier None Typical Low $7.41 Median $8.32 Typical High $10.23 | Facility | None | $7.41 | $8.32 | $10.23 |
Medica Setting Professional Modifier None Typical Low $3.55 Median $6.17 Typical High $63.10 | Professional | None | $3.55 | $6.17 | $63.10 |
Midlands Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.55 | Professional | None | $8.13 | $8.13 | $9.55 |
Midlands Setting Professional Modifier None Typical Low $8.51 Median $10.47 Typical High $15.85 | Professional | None | $8.51 | $10.47 | $15.85 |
Oscar Health Setting Professional Modifier None Typical Low $7.41 Median $10.23 Typical High $15.85 | Professional | None | $7.41 | $10.23 | $15.85 |
United Setting Professional Modifier None Typical Low $3.09 Median $3.63 Typical High $6.31 | Professional | None | $3.09 | $3.63 | $6.31 |
Wellmark Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | None | $5.89 | $5.89 | $5.89 |
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 $2.69 Median $3.55 Typical High $3.63 | Professional | 52 · Reduced service | $2.69 | $3.55 | $3.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.41 Typical High $1.45 | Professional | 53 · Discontinued | $1.07 | $1.41 | $1.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3.98 Median $5.37 Typical High $5.37 | Professional | 54 · Surgery only | $3.98 | $5.37 | $5.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $1.07 Typical High $1.07 | Professional | 55 · Aftercare only | $0.79 | $1.07 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.71 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.52 | $0.71 | $0.72 |
Where Iowa sits
The same service costs 2.7 times more in Hawaii 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
$7.24
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.