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 $371.54 Median $371.54 Typical High $371.54 | Facility | None | $371.54 | $371.54 | $371.54 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $331.13 Typical High $371.54 | Professional | None | $316.23 | $331.13 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $407.38 | Professional | None | $323.59 | $323.59 | $407.38 |
Hally Health Setting Professional Modifier None Typical Low $213.80 Median $309.03 Typical High $309.03 | Professional | None | $213.80 | $309.03 | $309.03 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $354.81 Typical High $380.19 | Facility | None | $309.03 | $354.81 | $380.19 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $316.23 Typical High $645.65 | Professional | None | $309.03 | $316.23 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $323.59 Median $407.38 Typical High $407.38 | Professional | None | $323.59 | $407.38 | $407.38 |
United Setting Facility Modifier None Typical Low $316.23 Median $316.23 Typical High $316.23 | Facility | None | $316.23 | $316.23 | $316.23 |
United Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $331.13 | Professional | None | $309.03 | $309.03 | $331.13 |
Wellmark Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Facility | None | $309.03 | $309.03 | $309.03 |
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 $186.21 Median $186.21 Typical High $186.21 | Facility | 52 · Reduced service | $186.21 | $186.21 | $186.21 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | 53 · Discontinued | $74.13 | $74.13 | $74.13 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | 55 · Aftercare only | $54.95 | $54.95 | $54.95 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | 56 · Pre-op care only | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $158.49 Median $165.96 Typical High $186.21 | Professional | 52 · Reduced service | $158.49 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $66.07 Typical High $74.13 | Professional | 53 · Discontinued | $64.57 | $66.07 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $48.98 Typical High $54.95 | Professional | 55 · Aftercare only | $47.86 | $48.98 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $33.11 Typical High $37.15 | Professional | 56 · Pre-op care only | $31.62 | $33.11 | $37.15 |
Where Iowa sits
The same service costs 1.6 times more in Arizona than in Rhode Island. 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
$309
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.