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 $22.91 Median $37.15 Typical High $37.15 | Facility | None | $22.91 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $22.39 Median $34.67 Typical High $37.15 | Professional | None | $22.39 | $34.67 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $28.84 Typical High $32.36 | Professional | None | $22.91 | $28.84 | $32.36 |
Hally Health Setting Professional Modifier None Typical Low $12.88 Median $23.44 Typical High $100.00 | Professional | None | $12.88 | $23.44 | $100.00 |
Medica Setting Facility Modifier None Typical Low $7.94 Median $30.90 Typical High $37.15 | Facility | None | $7.94 | $30.90 | $37.15 |
Medica Setting Professional Modifier None Typical Low $20.42 Median $24.55 Typical High $46.77 | Professional | None | $20.42 | $24.55 | $46.77 |
Midlands Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $37.15 | Professional | None | $30.20 | $30.20 | $37.15 |
United Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $24.55 | Professional | None | $22.91 | $22.91 | $24.55 |
Wellmark Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Facility | None | $22.91 | $22.91 | $22.91 |
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 $11.48 Median $18.62 Typical High $18.62 | Facility | 52 · Reduced service | $11.48 | $18.62 | $18.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.57 Median $7.41 Typical High $7.41 | Facility | 53 · Discontinued | $4.57 | $7.41 | $7.41 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.47 Median $5.62 Typical High $5.62 | Facility | 55 · Aftercare only | $3.47 | $5.62 | $5.62 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.29 Median $3.72 Typical High $3.72 | Facility | 56 · Pre-op care only | $2.29 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $11.22 Median $17.38 Typical High $18.62 | Professional | 52 · Reduced service | $11.22 | $17.38 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.47 Median $6.92 Typical High $7.41 | Professional | 53 · Discontinued | $4.47 | $6.92 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $5.25 Typical High $5.62 | Professional | 55 · Aftercare only | $3.39 | $5.25 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.24 Median $3.47 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.24 | $3.47 | $3.72 |
Where Iowa sits
The same service costs 1.9 times more in Alaska than in Mississippi. 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· 24th of 51
$23.99
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.