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 $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $346.74 | Professional | None | $194.98 | $229.09 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $218.78 | Professional | None | $173.78 | $173.78 | $218.78 |
Hally Health Setting Professional Modifier None Typical Low $44.67 Median $75.86 Typical High $151.36 | Professional | None | $44.67 | $75.86 | $151.36 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $190.55 Typical High $316.23 | Facility | None | $107.15 | $190.55 | $316.23 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $223.87 | Professional | None | $114.82 | $208.93 | $223.87 |
Midlands Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $117.49 | Professional | None | $117.49 | $117.49 | $117.49 |
Oscar Health Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
United Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $234.42 | Professional | None | $190.55 | $218.78 | $234.42 |
Wellmark Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
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 $114.82 Median $114.82 Typical High $114.82 | Facility | 52 · Reduced service | $114.82 | $114.82 | $114.82 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | 53 · Discontinued | $45.71 | $45.71 | $45.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $34.67 | Facility | 55 · Aftercare only | $34.67 | $34.67 | $34.67 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | 56 · Pre-op care only | $22.91 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $97.72 Median $97.72 Typical High $114.82 | Professional | 52 · Reduced service | $97.72 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.90 Median $38.90 Typical High $45.71 | Professional | 53 · Discontinued | $38.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $29.51 Median $29.51 Typical High $34.67 | Professional | 55 · Aftercare only | $29.51 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.50 Median $19.50 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.50 | $19.50 | $22.91 |
Where Iowa sits
The same service costs 549.5 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· 46th of 51
$191
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.