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 $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $181.97 | Professional | None | $144.54 | $169.82 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $141.25 Typical High $158.49 | Professional | None | $125.89 | $141.25 | $158.49 |
Hally Health Setting Professional Modifier None Typical Low $12.88 Median $18.62 Typical High $169.82 | Professional | None | $12.88 | $18.62 | $169.82 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $144.54 Typical High $186.21 | Facility | None | $131.83 | $144.54 | $186.21 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $194.98 | Professional | None | $120.23 | $151.36 | $194.98 |
Midlands Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $190.55 | Professional | None | $147.91 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $138.04 Median $154.88 Typical High $169.82 | Professional | None | $138.04 | $154.88 | $169.82 |
Wellmark Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
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 $85.11 Median $85.11 Typical High $85.11 | Facility | 52 · Reduced service | $85.11 | $85.11 | $85.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | 53 · Discontinued | $33.88 | $33.88 | $33.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | 55 · Aftercare only | $25.70 | $25.70 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $16.98 | Facility | 56 · Pre-op care only | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $72.44 Median $72.44 Typical High $85.11 | Professional | 52 · Reduced service | $72.44 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $28.84 Typical High $33.88 | Professional | 53 · Discontinued | $28.84 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $21.88 Typical High $25.70 | Professional | 55 · Aftercare only | $21.88 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $14.45 Typical High $16.98 | Professional | 56 · Pre-op care only | $14.45 | $14.45 | $16.98 |
Where Iowa sits
The same service costs 1.9 times more in Arizona than in New Mexico. 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
$145
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.