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 $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $524.81 Typical High $575.44 | Professional | None | $512.86 | $524.81 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $575.44 Typical High $645.65 | Professional | None | $524.81 | $575.44 | $645.65 |
Hally Health Setting Professional Modifier None Typical Low $338.84 Median $501.19 Typical High $1,479.11 | Professional | None | $338.84 | $501.19 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $575.44 Typical High $660.69 | Facility | None | $489.78 | $575.44 | $660.69 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $630.96 | Professional | None | $489.78 | $489.78 | $630.96 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $645.65 | Professional | None | $575.44 | $645.65 | $645.65 |
United Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $512.86 | Facility | None | $512.86 | $512.86 | $512.86 |
United Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $524.81 | Professional | None | $501.19 | $501.19 | $524.81 |
Wellmark Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Facility | None | $501.19 | $501.19 | $501.19 |
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 $288.40 Median $288.40 Typical High $288.40 | Facility | 52 · Reduced service | $288.40 | $288.40 | $288.40 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | 53 · Discontinued | $114.82 | $114.82 | $114.82 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | 55 · Aftercare only | $87.10 | $87.10 | $87.10 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | 56 · Pre-op care only | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $257.04 Median $263.03 Typical High $288.40 | Professional | 52 · Reduced service | $257.04 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $104.71 Typical High $114.82 | Professional | 53 · Discontinued | $102.33 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $79.43 Typical High $87.10 | Professional | 55 · Aftercare only | $75.86 | $79.43 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $52.48 Typical High $57.54 | Professional | 56 · Pre-op care only | $51.29 | $52.48 | $57.54 |
Where Iowa sits
The same service costs 2.8 times more in Arizona 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
$501
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.