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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $141.25 | Professional | None | $120.23 | $120.23 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $107.15 Typical High $131.83 | Professional | None | $30.20 | $107.15 | $131.83 |
Hally Health Setting Professional Modifier None Typical Low $12.88 Median $18.62 Typical High $165.96 | Professional | None | $12.88 | $18.62 | $165.96 |
Medica Setting Facility Modifier None Typical Low $37.15 Median $60.26 Typical High $128.82 | Facility | None | $37.15 | $60.26 | $128.82 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $117.49 Typical High $141.25 | Professional | None | $37.15 | $117.49 | $141.25 |
Midlands Setting Professional Modifier None Typical Low $30.20 Median $79.43 Typical High $79.43 | Professional | None | $30.20 | $79.43 | $79.43 |
United Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $144.54 | Professional | None | $117.49 | $131.83 | $144.54 |
Wellmark Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
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 $70.79 Median $70.79 Typical High $70.79 | Facility | 52 · Reduced service | $70.79 | $70.79 | $70.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | 53 · Discontinued | $28.18 | $28.18 | $28.18 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | 55 · Aftercare only | $20.89 | $20.89 | $20.89 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | 56 · Pre-op care only | $14.13 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $60.26 Median $60.26 Typical High $70.79 | Professional | 52 · Reduced service | $60.26 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $28.18 | Professional | 53 · Discontinued | $23.99 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $20.89 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $14.13 |
Where Iowa sits
The same service costs 5.1 times more in Arizona than in Alabama. 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· 48th of 51
$81.28
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.