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 $30.20 Median $32.36 Typical High $66.07 | Facility | None | $30.20 | $32.36 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $32.36 Typical High $44.67 | Professional | None | $30.20 | $32.36 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $38.02 | Professional | None | $28.18 | $30.90 | $38.02 |
Hally Health Setting Professional Modifier None Typical Low $22.91 Median $29.51 Typical High $48.98 | Professional | None | $22.91 | $29.51 | $48.98 |
Medica Setting Facility Modifier None Typical Low $20.89 Median $33.11 Typical High $36.31 | Facility | None | $20.89 | $33.11 | $36.31 |
Medica Setting Professional Modifier None Typical Low $25.12 Median $32.36 Typical High $52.48 | Professional | None | $25.12 | $32.36 | $52.48 |
Midlands Setting Professional Modifier None Typical Low $28.18 Median $38.02 Typical High $38.02 | Professional | None | $28.18 | $38.02 | $38.02 |
United Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $29.51 Median $31.62 Typical High $35.48 | Professional | None | $29.51 | $31.62 | $35.48 |
Wellmark Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
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 $15.14 Median $15.85 Typical High $22.39 | Facility | 52 · Reduced service | $15.14 | $15.85 | $22.39 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.03 Median $6.46 Typical High $8.91 | Facility | 53 · Discontinued | $6.03 | $6.46 | $8.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.47 Median $4.79 Typical High $6.61 | Facility | 55 · Aftercare only | $4.47 | $4.79 | $6.61 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.24 Typical High $4.47 | Facility | 56 · Pre-op care only | $3.02 | $3.24 | $4.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.14 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $15.14 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.46 Typical High $6.46 | Professional | 53 · Discontinued | $6.03 | $6.46 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.79 Typical High $4.79 | Professional | 55 · Aftercare only | $4.47 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.24 Typical High $3.24 | Professional | 56 · Pre-op care only | $3.02 | $3.24 | $3.24 |
Where Iowa sits
The same service costs 1.9 times more in Alaska 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· 39th of 51
$30.20
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.