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 $28.18 Median $43.65 Typical High $43.65 | Facility | None | $28.18 | $43.65 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $37.15 Typical High $43.65 | Professional | None | $28.18 | $37.15 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $29.51 Typical High $35.48 | Professional | None | $28.84 | $29.51 | $35.48 |
Hally Health Setting Professional Modifier None Typical Low $19.95 Median $26.30 Typical High $45.71 | Professional | None | $19.95 | $26.30 | $45.71 |
Medica Setting Facility Modifier None Typical Low $22.91 Median $28.84 Typical High $47.86 | Facility | None | $22.91 | $28.84 | $47.86 |
Medica Setting Professional Modifier None Typical Low $17.38 Median $18.20 Typical High $44.67 | Professional | None | $17.38 | $18.20 | $44.67 |
Midlands Setting Professional Modifier None Typical Low $29.51 Median $33.11 Typical High $33.11 | Professional | None | $29.51 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $26.92 | Professional | None | $24.55 | $24.55 | $26.92 |
Wellmark Setting Facility Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Facility | None | $24.55 | $24.55 | $24.55 |
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 $14.13 Median $21.88 Typical High $21.88 | Facility | 52 · Reduced service | $14.13 | $21.88 | $21.88 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.62 Median $8.71 Typical High $8.71 | Facility | 53 · Discontinued | $5.62 | $8.71 | $8.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.27 Median $6.61 Typical High $6.61 | Facility | 55 · Aftercare only | $4.27 | $6.61 | $6.61 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.82 Median $4.37 Typical High $4.37 | Facility | 56 · Pre-op care only | $2.82 | $4.37 | $4.37 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $18.20 Typical High $21.88 | Professional | 52 · Reduced service | $14.13 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $7.41 Typical High $8.71 | Professional | 53 · Discontinued | $5.62 | $7.41 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $5.50 Typical High $6.61 | Professional | 55 · Aftercare only | $4.27 | $5.50 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.72 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.82 | $3.72 | $4.37 |
Where Iowa sits
The same service costs 2.2 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· 50th of 51
$24.55
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.