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 $33.11 Median $33.11 Typical High $81.28 | Facility | None | $33.11 | $33.11 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $33.11 Median $43.65 Typical High $54.95 | Professional | None | $33.11 | $43.65 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $56.23 Typical High $64.57 | Professional | None | $44.67 | $56.23 | $64.57 |
Hally Health Setting Professional Modifier None Typical Low $50.12 Median $123.03 Typical High $158.49 | Professional | None | $50.12 | $123.03 | $158.49 |
Medica Setting Facility Modifier None Typical Low $33.11 Median $48.98 Typical High $109.65 | Facility | None | $33.11 | $48.98 | $109.65 |
Medica Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $147.91 | Professional | None | $61.66 | $67.61 | $147.91 |
Midlands Setting Professional Modifier None Typical Low $74.13 Median $77.62 Typical High $77.62 | Professional | None | $74.13 | $77.62 | $77.62 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | None | $54.95 | $54.95 | $60.26 |
Wellmark Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
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 $16.60 Median $16.60 Typical High $40.74 | Facility | 52 · Reduced service | $16.60 | $16.60 | $40.74 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.61 Median $6.61 Typical High $16.22 | Facility | 53 · Discontinued | $6.61 | $6.61 | $16.22 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.01 Median $5.01 Typical High $12.30 | Facility | 55 · Aftercare only | $5.01 | $5.01 | $12.30 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.31 Median $3.31 Typical High $8.13 | Facility | 56 · Pre-op care only | $3.31 | $3.31 | $8.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $16.60 Median $21.88 Typical High $26.92 | Professional | 52 · Reduced service | $16.60 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $8.71 Typical High $10.96 | Professional | 53 · Discontinued | $6.61 | $8.71 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $6.61 Typical High $8.13 | Professional | 55 · Aftercare only | $5.01 | $6.61 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $4.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $3.31 | $4.37 | $5.37 |
Where Iowa sits
The same service costs 2.0 times more in Alaska than in Wyoming. 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· 9th of 51
$54.95
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.