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 $87.10 Median $87.10 Typical High $112.20 | Facility | None | $87.10 | $87.10 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $125.89 | Professional | None | $75.86 | $87.10 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $87.10 Typical High $95.50 | Professional | None | $75.86 | $87.10 | $95.50 |
Hally Health Setting Professional Modifier None Typical Low $70.79 Median $77.62 Typical High $128.82 | Professional | None | $70.79 | $77.62 | $128.82 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $85.11 Typical High $162.18 | Facility | None | $74.13 | $85.11 | $162.18 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $131.83 | Professional | None | $70.79 | $83.18 | $131.83 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $97.72 Typical High $97.72 | Professional | None | $87.10 | $97.72 | $97.72 |
United Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $208.93 | Facility | None | $81.28 | $81.28 | $208.93 |
United Setting Professional Modifier None Typical Low $72.44 Median $81.28 Typical High $89.13 | Professional | None | $72.44 | $81.28 | $89.13 |
Wellmark Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
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 $37.15 Median $43.65 Typical High $56.23 | Facility | 52 · Reduced service | $37.15 | $43.65 | $56.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.14 Median $17.38 Typical High $22.91 | Facility | 53 · Discontinued | $15.14 | $17.38 | $22.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.22 Median $12.88 Typical High $16.98 | Facility | 55 · Aftercare only | $11.22 | $12.88 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.71 Typical High $11.22 | Facility | 56 · Pre-op care only | $7.59 | $8.71 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $37.15 Median $43.65 Typical High $43.65 | Professional | 52 · Reduced service | $37.15 | $43.65 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $15.14 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $11.22 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $8.71 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.59 | $8.71 | $8.71 |
Where Iowa sits
The same service costs 2.8 times more in Alaska 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· 22nd 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.