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 $52.48 Median $52.48 Typical High $97.72 | Facility | None | $52.48 | $52.48 | $97.72 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $52.48 | Professional | None | $41.69 | $52.48 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $51.29 Typical High $53.70 | Professional | None | $42.66 | $51.29 | $53.70 |
Hally Health Setting Professional Modifier None Typical Low $13.49 Median $43.65 Typical High $63.10 | Professional | None | $13.49 | $43.65 | $63.10 |
Medica Setting Facility Modifier None Typical Low $18.20 Median $57.54 Typical High $64.57 | Facility | None | $18.20 | $57.54 | $64.57 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $35.48 Typical High $75.86 | Professional | None | $28.84 | $35.48 | $75.86 |
Midlands Setting Professional Modifier None Typical Low $51.29 Median $56.23 Typical High $56.23 | Professional | None | $51.29 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $48.98 | Professional | None | $44.67 | $44.67 | $48.98 |
Wellmark Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
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 $22.39 Median $26.30 Typical High $33.11 | Facility | 52 · Reduced service | $22.39 | $26.30 | $33.11 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.91 Median $10.47 Typical High $13.49 | Facility | 53 · Discontinued | $8.91 | $10.47 | $13.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.61 Median $7.94 Typical High $10.00 | Facility | 55 · Aftercare only | $6.61 | $7.94 | $10.00 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.25 Typical High $6.76 | Facility | 56 · Pre-op care only | $4.47 | $5.25 | $6.76 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $26.30 Typical High $26.30 | Professional | 52 · Reduced service | $20.89 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $8.32 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $6.31 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.17 | $5.25 | $5.25 |
Where Iowa sits
The same service costs 1.8 times more in Arizona than in Georgia. 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· 28th of 51
$44.67
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.