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 $457.09 Median $537.03 Typical High $537.03 | Facility | None | $457.09 | $537.03 | $537.03 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $537.03 | Professional | None | $457.09 | $457.09 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $489.78 Typical High $616.60 | Professional | None | $389.05 | $489.78 | $616.60 |
Hally Health Setting Professional Modifier None Typical Low $12.88 Median $22.39 Typical High $281.84 | Professional | None | $12.88 | $22.39 | $281.84 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $389.05 Typical High $977.24 | Facility | None | $213.80 | $389.05 | $977.24 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $512.86 Typical High $616.60 | Professional | None | $269.15 | $512.86 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $398.11 | Professional | None | $194.98 | $194.98 | $398.11 |
United Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
United Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $549.54 | Professional | None | $457.09 | $512.86 | $549.54 |
Wellmark Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
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 $269.15 Median $269.15 Typical High $269.15 | Facility | 52 · Reduced service | $269.15 | $269.15 | $269.15 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | 53 · Discontinued | $109.65 | $109.65 | $109.65 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $81.28 Median $81.28 Typical High $81.28 | Facility | 55 · Aftercare only | $81.28 | $81.28 | $81.28 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | 56 · Pre-op care only | $53.70 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $229.09 Median $229.09 Typical High $269.15 | Professional | 52 · Reduced service | $229.09 | $229.09 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $93.33 Typical High $109.65 | Professional | 53 · Discontinued | $93.33 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $69.18 Typical High $81.28 | Professional | 55 · Aftercare only | $69.18 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $45.71 Typical High $53.70 | Professional | 56 · Pre-op care only | $45.71 | $45.71 | $53.70 |
Where Iowa sits
The same service costs 4.9 times more in Alabama than in Hawaii. 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
$457
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.