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 $50.12 Median $288.40 Typical High $288.40 | Facility | None | $50.12 | $288.40 | $288.40 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $52.48 Typical High $288.40 | Professional | None | $41.69 | $52.48 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $52.48 Typical High $134.90 | Professional | None | $42.66 | $52.48 | $134.90 |
Hally Health Setting Professional Modifier None Typical Low $63.10 Median $151.36 Typical High $323.59 | Professional | None | $63.10 | $151.36 | $323.59 |
Medica Setting Facility Modifier None Typical Low $32.36 Median $97.72 Typical High $288.40 | Facility | None | $32.36 | $97.72 | $288.40 |
Medica Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $208.93 | Professional | None | $32.36 | $38.02 | $208.93 |
Midlands Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $154.88 | Professional | None | $75.86 | $75.86 | $154.88 |
United Setting Facility Modifier None Typical Low $41.69 Median $41.69 Typical High $41.69 | Facility | None | $41.69 | $41.69 | $41.69 |
United Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $58.88 | Professional | None | $50.12 | $54.95 | $58.88 |
Wellmark Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
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 $25.12 Median $144.54 Typical High $144.54 | Facility | 52 · Reduced service | $25.12 | $144.54 | $144.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $10.00 Median $57.54 Typical High $57.54 | Facility | 53 · Discontinued | $10.00 | $57.54 | $57.54 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.41 Median $43.65 Typical High $43.65 | Facility | 55 · Aftercare only | $7.41 | $43.65 | $43.65 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.01 Median $28.84 Typical High $28.84 | Facility | 56 · Pre-op care only | $5.01 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $37.15 Typical High $144.54 | Professional | 52 · Reduced service | $20.89 | $37.15 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $15.14 Typical High $57.54 | Professional | 53 · Discontinued | $8.32 | $15.14 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $11.22 Typical High $43.65 | Professional | 55 · Aftercare only | $6.17 | $11.22 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $7.59 Typical High $28.84 | Professional | 56 · Pre-op care only | $4.17 | $7.59 | $28.84 |
Where Iowa sits
The same service costs 3.9 times more in Wyoming than in Georgia. 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
$50.12
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.