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 $234.42 Typical High $245.47 | Facility | None | $169.82 | $234.42 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $234.42 | Professional | None | $169.82 | $234.42 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $181.97 Typical High $218.78 | Professional | None | $173.78 | $181.97 | $218.78 |
Hally Health Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $389.05 | Professional | None | $165.96 | $204.17 | $389.05 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $199.53 Typical High $354.81 | Facility | None | $169.82 | $199.53 | $354.81 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $288.40 | Professional | None | $165.96 | $186.21 | $288.40 |
Midlands Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $213.80 | Professional | None | $181.97 | $213.80 | $213.80 |
United Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $537.03 | Facility | None | $213.80 | $213.80 | $537.03 |
United Setting Professional Modifier None Typical Low $165.96 Median $186.21 Typical High $234.42 | Professional | None | $165.96 | $186.21 | $234.42 |
Wellmark Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
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 $117.49 Typical High $123.03 | Facility | 52 · Reduced service | $85.11 | $117.49 | $123.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $33.88 Median $46.77 Typical High $50.12 | Facility | 53 · Discontinued | $33.88 | $46.77 | $50.12 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $35.48 Typical High $37.15 | Facility | 55 · Aftercare only | $25.70 | $35.48 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $16.98 Median $23.44 Typical High $24.55 | Facility | 56 · Pre-op care only | $16.98 | $23.44 | $24.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $85.11 Median $117.49 Typical High $117.49 | Professional | 52 · Reduced service | $85.11 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $46.77 Typical High $46.77 | Professional | 53 · Discontinued | $33.88 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $35.48 Typical High $35.48 | Professional | 55 · Aftercare only | $25.70 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $23.44 Typical High $23.44 | Professional | 56 · Pre-op care only | $16.98 | $23.44 | $23.44 |
Where Iowa sits
The same service costs 1.8 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· 35th of 51
$186
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.