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 $11.22 Median $40.74 Typical High $40.74 | Facility | None | $11.22 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $13.80 Typical High $40.74 | Professional | None | $10.96 | $13.80 | $40.74 |
Cigna Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Facility | None | $11.22 | $11.22 | $11.22 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $14.13 Typical High $15.14 | Professional | None | $11.22 | $14.13 | $15.14 |
Hally Health Setting Professional Modifier None Typical Low $10.96 Median $29.51 Typical High $70.79 | Professional | None | $10.96 | $29.51 | $70.79 |
Medica Setting Facility Modifier None Typical Low $10.96 Median $13.18 Typical High $40.74 | Facility | None | $10.96 | $13.18 | $40.74 |
Medica Setting Professional Modifier None Typical Low $10.96 Median $11.48 Typical High $46.77 | Professional | None | $10.96 | $11.48 | $46.77 |
Midlands Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $16.98 | Professional | None | $15.14 | $15.14 | $16.98 |
United Setting Facility Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
United Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $12.02 | Professional | None | $11.22 | $11.22 | $12.02 |
Wellmark Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Facility | None | $11.22 | $11.22 | $11.22 |
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 $5.62 Median $20.42 Typical High $20.42 | Facility | 52 · Reduced service | $5.62 | $20.42 | $20.42 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.24 Median $8.32 Typical High $8.32 | Facility | 53 · Discontinued | $2.24 | $8.32 | $8.32 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.70 Median $6.17 Typical High $6.17 | Facility | 55 · Aftercare only | $1.70 | $6.17 | $6.17 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.12 Median $4.07 Typical High $4.07 | Facility | 56 · Pre-op care only | $1.12 | $4.07 | $4.07 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $5.50 Median $8.51 Typical High $20.42 | Professional | 52 · Reduced service | $5.50 | $8.51 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $3.39 Typical High $8.32 | Professional | 53 · Discontinued | $2.19 | $3.39 | $8.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $2.57 Typical High $6.17 | Professional | 55 · Aftercare only | $1.66 | $2.57 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.70 Typical High $4.07 | Professional | 56 · Pre-op care only | $1.10 | $1.70 | $4.07 |
Where Iowa sits
The same service costs 3.7 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· 42nd of 51
$11.22
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.