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 $14.13 Median $44.67 Typical High $44.67 | Facility | None | $14.13 | $44.67 | $44.67 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $14.13 Typical High $44.67 | Professional | None | $8.51 | $14.13 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $8.71 Median $10.72 Typical High $26.30 | Professional | None | $8.71 | $10.72 | $26.30 |
Hally Health Setting Professional Modifier None Typical Low $11.48 Median $28.18 Typical High $79.43 | Professional | None | $11.48 | $28.18 | $79.43 |
Medica Setting Facility Modifier None Typical Low $15.49 Median $22.39 Typical High $66.07 | Facility | None | $15.49 | $22.39 | $66.07 |
Medica Setting Professional Modifier None Typical Low $11.75 Median $12.30 Typical High $91.20 | Professional | None | $11.75 | $12.30 | $91.20 |
Midlands Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $29.51 | Professional | None | $14.79 | $14.79 | $29.51 |
United Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $10.23 | Professional | None | $9.33 | $9.33 | $10.23 |
Wellmark Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
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 $4.68 Median $22.39 Typical High $22.39 | Facility | 52 · Reduced service | $4.68 | $22.39 | $22.39 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.86 Median $8.91 Typical High $8.91 | Facility | 53 · Discontinued | $1.86 | $8.91 | $8.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.41 Median $6.61 Typical High $6.61 | Facility | 55 · Aftercare only | $1.41 | $6.61 | $6.61 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.93 Median $4.47 Typical High $4.47 | Facility | 56 · Pre-op care only | $0.93 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $4.27 Median $7.08 Typical High $22.39 | Professional | 52 · Reduced service | $4.27 | $7.08 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $2.82 Typical High $8.91 | Professional | 53 · Discontinued | $1.70 | $2.82 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.29 Median $2.14 Typical High $6.61 | Professional | 55 · Aftercare only | $1.29 | $2.14 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $1.41 Typical High $4.47 | Professional | 56 · Pre-op care only | $0.85 | $1.41 | $4.47 |
Where Iowa sits
The same service costs 6.5 times more in Oklahoma 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· 11th of 51
$11.75
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.