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 $831.76 Median $831.76 Typical High $1,737.80 | Facility | None | $831.76 | $831.76 | $1,737.80 |
Aetna Setting Professional Modifier None Typical Low $776.25 Median $831.76 Typical High $831.76 | Professional | None | $776.25 | $831.76 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $1,174.90 Median $1,445.44 Typical High $2,089.30 | Professional | None | $1,174.90 | $1,445.44 | $2,089.30 |
Hally Health Setting Professional Modifier None Typical Low $66.07 Median $1,148.15 Typical High $2,454.71 | Professional | None | $66.07 | $1,148.15 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $69.18 Median $1,380.38 Typical High $2,344.23 | Facility | None | $69.18 | $1,380.38 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $549.54 Median $794.33 Typical High $4,786.30 | Professional | None | $549.54 | $794.33 | $4,786.30 |
Midlands Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $2,398.83 | Professional | None | $53.70 | $53.70 | $2,398.83 |
United Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $851.14 | Professional | None | $794.33 | $794.33 | $851.14 |
Wellmark Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
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 $416.87 Median $416.87 Typical High $870.96 | Facility | 52 · Reduced service | $416.87 | $416.87 | $870.96 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $165.96 Median $165.96 Typical High $346.74 | Facility | 53 · Discontinued | $165.96 | $165.96 | $346.74 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $125.89 Median $125.89 Typical High $257.04 | Facility | 55 · Aftercare only | $125.89 | $125.89 | $257.04 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $83.18 Median $83.18 Typical High $173.78 | Facility | 56 · Pre-op care only | $83.18 | $83.18 | $173.78 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $380.19 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $380.19 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $154.88 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $114.82 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $114.82 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $77.62 | $83.18 | $83.18 |
Where Iowa sits
The same service costs 2.6 times more in Alabama than in Florida. 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· 50th of 51
$794
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.