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 $398.11 Median $467.74 Typical High $588.84 | Facility | None | $398.11 | $467.74 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $467.74 | Professional | None | $398.11 | $467.74 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $436.52 Typical High $512.86 | Professional | None | $407.38 | $436.52 | $512.86 |
Hally Health Setting Professional Modifier None Typical Low $100.00 Median $346.74 Typical High $389.05 | Professional | None | $100.00 | $346.74 | $389.05 |
Medica Setting Facility Modifier None Typical Low $275.42 Median $457.09 Typical High $501.19 | Facility | None | $275.42 | $457.09 | $501.19 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $707.95 | Professional | None | $288.40 | $389.05 | $707.95 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $512.86 Typical High $512.86 | Professional | None | $436.52 | $512.86 | $512.86 |
United Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
United Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $416.87 | Professional | None | $389.05 | $389.05 | $416.87 |
Wellmark Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
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 $199.53 Median $234.42 Typical High $295.12 | Facility | 52 · Reduced service | $199.53 | $234.42 | $295.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $79.43 Median $93.33 Typical High $117.49 | Facility | 53 · Discontinued | $79.43 | $93.33 | $117.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $60.26 Median $69.18 Typical High $89.13 | Facility | 55 · Aftercare only | $60.26 | $69.18 | $89.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $39.81 Median $46.77 Typical High $58.88 | Facility | 56 · Pre-op care only | $39.81 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $199.53 Median $234.42 Typical High $234.42 | Professional | 52 · Reduced service | $199.53 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $79.43 Median $93.33 Typical High $93.33 | Professional | 53 · Discontinued | $79.43 | $93.33 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $60.26 Median $69.18 Typical High $69.18 | Professional | 55 · Aftercare only | $60.26 | $69.18 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $39.81 Median $46.77 Typical High $46.77 | Professional | 56 · Pre-op care only | $39.81 | $46.77 | $46.77 |
Where Iowa sits
The same service costs 2.8 times more in Arizona than in Alabama. 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· 43rd of 51
$389
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.