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 $102.33 Median $102.33 Typical High $173.78 | Facility | None | $102.33 | $102.33 | $173.78 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $173.78 | Professional | None | $102.33 | $138.04 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $218.78 | Professional | None | $102.33 | $173.78 | $218.78 |
Hally Health Setting Professional Modifier None Typical Low $8.91 Median $64.57 Typical High $245.47 | Professional | None | $8.91 | $64.57 | $245.47 |
Medica Setting Facility Modifier None Typical Low $10.00 Median $79.43 Typical High $104.71 | Facility | None | $10.00 | $79.43 | $104.71 |
Medica Setting Professional Modifier None Typical Low $56.23 Median $75.86 Typical High $134.90 | Professional | None | $56.23 | $75.86 | $134.90 |
Midlands Setting Professional Modifier None Typical Low $26.30 Median $26.30 Typical High $102.33 | Professional | None | $26.30 | $26.30 | $102.33 |
United Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $97.72 | Professional | None | $91.20 | $91.20 | $97.72 |
Wellmark Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
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 $51.29 Median $51.29 Typical High $87.10 | Facility | 52 · Reduced service | $51.29 | $51.29 | $87.10 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $34.67 | Facility | 53 · Discontinued | $20.42 | $20.42 | $34.67 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $25.70 | Facility | 55 · Aftercare only | $15.14 | $15.14 | $25.70 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $17.38 | Facility | 56 · Pre-op care only | $10.23 | $10.23 | $17.38 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $51.29 Median $69.18 Typical High $87.10 | Professional | 52 · Reduced service | $51.29 | $69.18 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $27.54 Typical High $34.67 | Professional | 53 · Discontinued | $20.42 | $27.54 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $20.89 Typical High $25.70 | Professional | 55 · Aftercare only | $15.14 | $20.89 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $13.80 Typical High $17.38 | Professional | 56 · Pre-op care only | $10.23 | $13.80 | $17.38 |
Where Iowa sits
The same service costs 3.2 times more in Wyoming 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· 48th of 51
$91.20
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.