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 $33.88 Median $75.86 Typical High $75.86 | Facility | None | $33.88 | $75.86 | $75.86 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $51.29 Typical High $75.86 | Professional | None | $31.62 | $51.29 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $39.81 Typical High $44.67 | Professional | None | $32.36 | $39.81 | $44.67 |
Hally Health Setting Professional Modifier None Typical Low $39.81 Median $63.10 Typical High $177.83 | Professional | None | $39.81 | $63.10 | $177.83 |
Medica Setting Facility Modifier None Typical Low $34.67 Median $47.86 Typical High $104.71 | Facility | None | $34.67 | $47.86 | $104.71 |
Medica Setting Professional Modifier None Typical Low $38.90 Median $39.81 Typical High $120.23 | Professional | None | $38.90 | $39.81 | $120.23 |
Midlands Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $51.29 | Professional | None | $43.65 | $43.65 | $51.29 |
United Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $37.15 | Professional | None | $33.88 | $33.88 | $37.15 |
Wellmark Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
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 $16.98 Median $38.02 Typical High $38.02 | Facility | 52 · Reduced service | $16.98 | $38.02 | $38.02 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.76 Median $15.14 Typical High $15.14 | Facility | 53 · Discontinued | $6.76 | $15.14 | $15.14 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.13 Median $11.22 Typical High $11.22 | Facility | 55 · Aftercare only | $5.13 | $11.22 | $11.22 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.39 Median $7.59 Typical High $7.59 | Facility | 56 · Pre-op care only | $3.39 | $7.59 | $7.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.85 Median $25.70 Typical High $38.02 | Professional | 52 · Reduced service | $15.85 | $25.70 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $10.23 Typical High $15.14 | Professional | 53 · Discontinued | $6.31 | $10.23 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $7.76 Typical High $11.22 | Professional | 55 · Aftercare only | $4.68 | $7.76 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $5.13 Typical High $7.59 | Professional | 56 · Pre-op care only | $3.16 | $5.13 | $7.59 |
Where Iowa sits
The same service costs 2.3 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· 12th of 51
$38.90
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.