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 $54.95 Median $93.33 Typical High $93.33 | Facility | None | $54.95 | $93.33 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $63.10 Typical High $93.33 | Professional | None | $54.95 | $63.10 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $70.79 | Professional | None | $56.23 | $66.07 | $70.79 |
Hally Health Setting Professional Modifier None Typical Low $44.67 Median $60.26 Typical High $199.53 | Professional | None | $44.67 | $60.26 | $199.53 |
Medica Setting Facility Modifier None Typical Low $33.88 Median $69.18 Typical High $131.83 | Facility | None | $33.88 | $69.18 | $131.83 |
Medica Setting Professional Modifier None Typical Low $46.77 Median $97.72 Typical High $147.91 | Professional | None | $46.77 | $97.72 | $147.91 |
Midlands Setting Professional Modifier None Typical Low $70.79 Median $74.13 Typical High $74.13 | Professional | None | $70.79 | $74.13 | $74.13 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $60.26 | Professional | None | $54.95 | $54.95 | $60.26 |
Wellmark Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
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 $27.54 Median $46.77 Typical High $46.77 | Facility | 52 · Reduced service | $27.54 | $46.77 | $46.77 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.96 Median $18.62 Typical High $18.62 | Facility | 53 · Discontinued | $10.96 | $18.62 | $18.62 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.32 Median $14.13 Typical High $14.13 | Facility | 55 · Aftercare only | $8.32 | $14.13 | $14.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.50 Median $9.33 Typical High $9.33 | Facility | 56 · Pre-op care only | $5.50 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $27.54 Median $41.69 Typical High $46.77 | Professional | 52 · Reduced service | $27.54 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $16.60 Typical High $18.62 | Professional | 53 · Discontinued | $10.96 | $16.60 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $12.30 Typical High $14.13 | Professional | 55 · Aftercare only | $8.32 | $12.30 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $8.32 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.50 | $8.32 | $9.33 |
Where Iowa sits
The same service costs 2.7 times more in Oklahoma than in West Virginia. 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· 28th of 51
$57.54
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.