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 $208.93 Median $208.93 Typical High $316.23 | Facility | None | $208.93 | $208.93 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $218.78 | Professional | None | $208.93 | $208.93 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $234.42 Typical High $269.15 | Professional | None | $213.80 | $234.42 | $269.15 |
Hally Health Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $457.09 | Professional | None | $144.54 | $208.93 | $457.09 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $239.88 Typical High $275.42 | Facility | None | $204.17 | $239.88 | $275.42 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $208.93 Typical High $371.54 | Professional | None | $199.53 | $208.93 | $371.54 |
Midlands Setting Professional Modifier None Typical Low $234.42 Median $269.15 Typical High $269.15 | Professional | None | $234.42 | $269.15 | $269.15 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $218.78 | Professional | None | $208.93 | $208.93 | $218.78 |
Wellmark Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
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 $104.71 Median $104.71 Typical High $154.88 | Facility | 52 · Reduced service | $104.71 | $104.71 | $154.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $41.69 Typical High $63.10 | Facility | 53 · Discontinued | $41.69 | $41.69 | $63.10 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $46.77 | Facility | 55 · Aftercare only | $31.62 | $31.62 | $46.77 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $31.62 | Facility | 56 · Pre-op care only | $20.89 | $20.89 | $31.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $104.71 Typical High $109.65 | Professional | 52 · Reduced service | $104.71 | $104.71 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $42.66 Typical High $43.65 | Professional | 53 · Discontinued | $41.69 | $42.66 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $32.36 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $21.88 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $21.88 |
Where Iowa sits
The same service costs 1.6 times more in Arizona than in New Jersey. 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· 43rd of 51
$209
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.