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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $57.54 | Professional | None | $32.36 | $38.02 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $35.48 Typical High $37.15 | Professional | None | $29.51 | $35.48 | $37.15 |
Hally Health Setting Professional Modifier None Typical Low $12.88 Median $21.88 Typical High $44.67 | Professional | None | $12.88 | $21.88 | $44.67 |
Medica Setting Facility Modifier None Typical Low $34.67 Median $40.74 Typical High $57.54 | Facility | None | $34.67 | $40.74 | $57.54 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $36.31 Typical High $57.54 | Professional | None | $32.36 | $36.31 | $57.54 |
Midlands Setting Professional Modifier None Typical Low $35.48 Median $60.26 Typical High $60.26 | Professional | None | $35.48 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $30.90 Median $34.67 Typical High $38.02 | Professional | None | $30.90 | $34.67 | $38.02 |
Wellmark Setting Facility Modifier None Typical Low $31.62 Median $31.62 Typical High $31.62 | Facility | None | $31.62 | $31.62 | $31.62 |
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 $18.62 Median $18.62 Typical High $18.62 | Facility | 52 · Reduced service | $18.62 | $18.62 | $18.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $7.59 | Facility | 53 · Discontinued | $7.59 | $7.59 | $7.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $5.62 | Facility | 55 · Aftercare only | $5.62 | $5.62 | $5.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $3.80 | Facility | 56 · Pre-op care only | $3.80 | $3.80 | $3.80 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $16.22 Typical High $18.62 | Professional | 52 · Reduced service | $16.22 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $7.59 | Professional | 53 · Discontinued | $6.46 | $6.46 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $4.79 Typical High $5.62 | Professional | 55 · Aftercare only | $4.79 | $4.79 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.80 |
Where Iowa sits
The same service costs 97.7 times more in Arizona 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· 35th of 51
$34.67
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.