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 $14.45 Median $29.51 Typical High $29.51 | Facility | None | $14.45 | $29.51 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $14.45 Median $21.38 Typical High $29.51 | Professional | None | $14.45 | $21.38 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $14.79 Median $16.98 Typical High $18.62 | Professional | None | $14.79 | $16.98 | $18.62 |
Hally Health Setting Professional Modifier None Typical Low $13.18 Median $17.78 Typical High $79.43 | Professional | None | $13.18 | $17.78 | $79.43 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $16.60 Typical High $29.51 | Facility | None | $14.45 | $16.60 | $29.51 |
Medica Setting Professional Modifier None Typical Low $11.48 Median $12.02 Typical High $30.20 | Professional | None | $11.48 | $12.02 | $30.20 |
Midlands Setting Professional Modifier None Typical Low $15.85 Median $15.85 Typical High $19.50 | Professional | None | $15.85 | $15.85 | $19.50 |
United Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $15.85 | Professional | None | $14.13 | $14.13 | $15.85 |
Wellmark Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
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 $7.24 Median $14.79 Typical High $14.79 | Facility | 52 · Reduced service | $7.24 | $14.79 | $14.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.88 Median $5.89 Typical High $5.89 | Facility | 53 · Discontinued | $2.88 | $5.89 | $5.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $2.19 Median $4.37 Typical High $4.37 | Facility | 55 · Aftercare only | $2.19 | $4.37 | $4.37 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.45 Median $2.95 Typical High $2.95 | Facility | 56 · Pre-op care only | $1.45 | $2.95 | $2.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $7.24 Median $10.72 Typical High $14.79 | Professional | 52 · Reduced service | $7.24 | $10.72 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.88 Median $4.27 Typical High $5.89 | Professional | 53 · Discontinued | $2.88 | $4.27 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.19 Median $3.24 Typical High $4.37 | Professional | 55 · Aftercare only | $2.19 | $3.24 | $4.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $2.14 Typical High $2.95 | Professional | 56 · Pre-op care only | $1.45 | $2.14 | $2.95 |
Where Iowa sits
The same service costs 2.0 times more in Wyoming than in Oklahoma. 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· 48th of 51
$14.13
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.