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 $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $426.58 | Professional | None | $245.47 | $245.47 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $309.03 | Professional | None | $245.47 | $288.40 | $309.03 |
Hally Health Setting Professional Modifier None Typical Low $245.47 Median $288.40 Typical High $660.69 | Professional | None | $245.47 | $288.40 | $660.69 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $323.59 Typical High $426.58 | Facility | None | $234.42 | $323.59 | $426.58 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $281.84 Typical High $426.58 | Professional | None | $234.42 | $281.84 | $426.58 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $309.03 Typical High $309.03 | Professional | None | $302.00 | $309.03 | $309.03 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $239.88 Median $275.42 Typical High $426.58 | Professional | None | $239.88 | $275.42 | $426.58 |
Wellmark Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
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 $213.80 Median $213.80 Typical High $213.80 | Facility | 52 · Reduced service | $213.80 | $213.80 | $213.80 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | 53 · Discontinued | $85.11 | $85.11 | $85.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | 55 · Aftercare only | $64.57 | $64.57 | $64.57 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | 56 · Pre-op care only | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $120.23 Median $120.23 Typical High $213.80 | Professional | 52 · Reduced service | $120.23 | $120.23 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $48.98 Typical High $85.11 | Professional | 53 · Discontinued | $48.98 | $48.98 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $36.31 Typical High $64.57 | Professional | 55 · Aftercare only | $36.31 | $36.31 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $24.55 Typical High $42.66 | Professional | 56 · Pre-op care only | $24.55 | $24.55 | $42.66 |
Where Iowa sits
The same service costs 8.7 times more in Alabama than in Rhode Island. 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· 36th of 51
$269
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.