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 $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $58.88 | Professional | None | $46.77 | $50.12 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $51.29 | Professional | None | $40.74 | $44.67 | $51.29 |
Hally Health Setting Professional Modifier None Typical Low $17.78 Median $46.77 Typical High $57.54 | Professional | None | $17.78 | $46.77 | $57.54 |
Medica Setting Facility Modifier None Typical Low $26.92 Median $45.71 Typical High $58.88 | Facility | None | $26.92 | $45.71 | $58.88 |
Medica Setting Professional Modifier None Typical Low $26.92 Median $48.98 Typical High $85.11 | Professional | None | $26.92 | $48.98 | $85.11 |
Midlands Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $51.29 | Professional | None | $30.20 | $30.20 | $51.29 |
United Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $51.29 | Professional | None | $48.98 | $48.98 | $51.29 |
Wellmark Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
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 $29.51 Median $29.51 Typical High $29.51 | Facility | 52 · Reduced service | $29.51 | $29.51 | $29.51 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $11.75 | Facility | 53 · Discontinued | $11.75 | $11.75 | $11.75 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $8.71 | Facility | 55 · Aftercare only | $8.71 | $8.71 | $8.71 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $5.89 | Facility | 56 · Pre-op care only | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $23.44 Median $24.55 Typical High $29.51 | Professional | 52 · Reduced service | $23.44 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.00 Typical High $11.75 | Professional | 53 · Discontinued | $9.33 | $10.00 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.41 Typical High $8.71 | Professional | 55 · Aftercare only | $7.08 | $7.41 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.01 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.68 | $5.01 | $5.89 |
Where Iowa sits
The same service costs 1.7 times more in Alaska than in Montana. 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· 47th of 51
$48.98
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.