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 $7.76 Median $16.22 Typical High $17.38 | Facility | None | $7.76 | $16.22 | $17.38 |
Aetna Setting Professional Modifier None Typical Low $7.76 Median $12.30 Typical High $16.22 | Professional | None | $7.76 | $12.30 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $7.94 Typical High $10.00 | Professional | None | $5.25 | $7.94 | $10.00 |
Hally Health Setting Professional Modifier None Typical Low $9.33 Median $11.22 Typical High $22.39 | Professional | None | $9.33 | $11.22 | $22.39 |
Medica Setting Facility Modifier None Typical Low $5.13 Median $16.98 Typical High $40.74 | Facility | None | $5.13 | $16.98 | $40.74 |
Medica Setting Professional Modifier None Typical Low $8.13 Median $9.33 Typical High $17.78 | Professional | None | $8.13 | $9.33 | $17.78 |
Midlands Setting Professional Modifier None Typical Low $5.25 Median $8.32 Typical High $8.32 | Professional | None | $5.25 | $8.32 | $8.32 |
United Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.12 | Professional | None | $8.13 | $8.13 | $9.12 |
Wellmark Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
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 $4.07 Median $8.13 Typical High $8.13 | Facility | 52 · Reduced service | $4.07 | $8.13 | $8.13 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $1.62 Median $3.31 Typical High $3.31 | Facility | 53 · Discontinued | $1.62 | $3.31 | $3.31 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.23 Median $2.45 Typical High $2.45 | Facility | 55 · Aftercare only | $1.23 | $2.45 | $2.45 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $0.81 Median $1.62 Typical High $1.62 | Facility | 56 · Pre-op care only | $0.81 | $1.62 | $1.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $3.89 Median $6.17 Typical High $8.13 | Professional | 52 · Reduced service | $3.89 | $6.17 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.55 Median $2.45 Typical High $3.31 | Professional | 53 · Discontinued | $1.55 | $2.45 | $3.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.17 Median $1.86 Typical High $2.45 | Professional | 55 · Aftercare only | $1.17 | $1.86 | $2.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.78 Median $1.23 Typical High $1.62 | Professional | 56 · Pre-op care only | $0.78 | $1.23 | $1.62 |
Where Iowa sits
The same service costs 2.6 times more in Texas 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· 15th of 51
$9.33
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.