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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $112.20 Typical High $131.83 | Professional | None | $109.65 | $112.20 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $141.25 | Professional | None | $112.20 | $112.20 | $141.25 |
Hally Health Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $416.87 | Professional | None | $104.71 | $104.71 | $416.87 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $120.23 Typical High $131.83 | Facility | None | $104.71 | $120.23 | $131.83 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $107.15 Typical High $239.88 | Professional | None | $104.71 | $107.15 | $239.88 |
Midlands Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $134.90 | Professional | None | $112.20 | $134.90 | $134.90 |
United Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $112.20 | Professional | None | $104.71 | $104.71 | $112.20 |
Wellmark Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
10 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 $66.07 Median $66.07 Typical High $66.07 | Facility | 52 · Reduced service | $66.07 | $66.07 | $66.07 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $26.30 Median $26.30 Typical High $26.30 | Facility | 53 · Discontinued | $26.30 | $26.30 | $26.30 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | 54 · Surgery only | $97.72 | $97.72 | $97.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $19.50 | Facility | 55 · Aftercare only | $19.50 | $19.50 | $19.50 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $13.18 Median $13.18 Typical High $13.18 | Facility | 56 · Pre-op care only | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $54.95 Median $56.23 Typical High $66.07 | Professional | 52 · Reduced service | $54.95 | $56.23 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $22.39 Typical High $26.30 | Professional | 53 · Discontinued | $21.88 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $85.11 Typical High $97.72 | Professional | 54 · Surgery only | $83.18 | $85.11 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.98 Typical High $19.50 | Professional | 55 · Aftercare only | $16.60 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $11.22 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.96 | $11.22 | $13.18 |
Where Iowa sits
The same service costs 5.0 times more in Alabama than in Maryland. 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· 46th of 51
$107
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.