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 $234.42 Median $239.88 Typical High $467.74 | Facility | None | $234.42 | $239.88 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $239.88 Typical High $281.84 | Professional | None | $208.93 | $239.88 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $223.87 Typical High $263.03 | Professional | None | $213.80 | $223.87 | $263.03 |
Hally Health Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $346.74 | Professional | None | $144.54 | $204.17 | $346.74 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $245.47 Typical High $295.12 | Facility | None | $208.93 | $245.47 | $295.12 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $245.47 Typical High $389.05 | Professional | None | $213.80 | $245.47 | $389.05 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $257.04 Typical High $257.04 | Professional | None | $251.19 | $257.04 | $257.04 |
United Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Facility | None | $208.93 | $208.93 | $208.93 |
United Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $223.87 | Professional | None | $186.21 | $208.93 | $223.87 |
Wellmark Setting Facility Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
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 $104.71 Median $120.23 Typical High $141.25 | Facility | 52 · Reduced service | $104.71 | $120.23 | $141.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $41.69 Median $47.86 Typical High $56.23 | Facility | 53 · Discontinued | $41.69 | $47.86 | $56.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $30.90 Median $36.31 Typical High $42.66 | Facility | 55 · Aftercare only | $30.90 | $36.31 | $42.66 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.99 Typical High $28.18 | Facility | 56 · Pre-op care only | $20.89 | $23.99 | $28.18 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $104.71 Median $120.23 Typical High $120.23 | Professional | 52 · Reduced service | $104.71 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $47.86 Typical High $47.86 | Professional | 53 · Discontinued | $41.69 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $36.31 Typical High $36.31 | Professional | 55 · Aftercare only | $30.90 | $36.31 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $23.99 Typical High $23.99 | Professional | 56 · Pre-op care only | $20.89 | $23.99 | $23.99 |
Where Iowa sits
The same service costs 1.6 times more in Arizona than in Rhode Island. 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· 19th of 51
$214
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.