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 $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Aetna Setting Professional Modifier None Typical Low $32.36 Median $36.31 Typical High $61.66 | Professional | None | $32.36 | $36.31 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $34.67 Typical High $36.31 | Professional | None | $28.84 | $34.67 | $36.31 |
Hally Health Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $52.48 | Professional | None | $28.84 | $33.88 | $52.48 |
Medica Setting Facility Modifier None Typical Low $33.88 Median $36.31 Typical High $51.29 | Facility | None | $33.88 | $36.31 | $51.29 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $35.48 Typical High $51.29 | Professional | None | $28.84 | $35.48 | $51.29 |
Midlands Setting Professional Modifier None Typical Low $34.67 Median $52.48 Typical High $52.48 | Professional | None | $34.67 | $52.48 | $52.48 |
United Setting Professional Modifier None Typical Low $30.90 Median $35.48 Typical High $38.02 | Professional | None | $30.90 | $35.48 | $38.02 |
Wellmark Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
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 $18.20 Median $18.20 Typical High $18.20 | Facility | 52 · Reduced service | $18.20 | $18.20 | $18.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $7.24 | Facility | 53 · Discontinued | $7.24 | $7.24 | $7.24 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $5.50 | Facility | 55 · Aftercare only | $5.50 | $5.50 | $5.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $3.63 | Facility | 56 · Pre-op care only | $3.63 | $3.63 | $3.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.22 Median $16.22 Typical High $18.20 | Professional | 52 · Reduced service | $16.22 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $6.46 Typical High $7.24 | Professional | 53 · Discontinued | $6.46 | $6.46 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $4.90 Typical High $5.50 | Professional | 55 · Aftercare only | $4.90 | $4.90 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.24 Typical High $3.63 | Professional | 56 · Pre-op care only | $3.24 | $3.24 | $3.63 |
Where Iowa sits
The same service costs 5.4 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· 33rd of 51
$33.88
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.