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 $44.67 Median $44.67 Typical High $70.79 | Facility | None | $44.67 | $44.67 | $70.79 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $38.02 Typical High $44.67 | Professional | None | $36.31 | $38.02 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $1.51 Median $1.86 Typical High $41.69 | Professional | None | $1.51 | $1.86 | $41.69 |
Hally Health Setting Professional Modifier None Typical Low $1.02 Median $4.27 Typical High $56.23 | Professional | None | $1.02 | $4.27 | $56.23 |
Medica Setting Facility Modifier None Typical Low $3.09 Median $3.31 Typical High $45.71 | Facility | None | $3.09 | $3.31 | $45.71 |
Medica Setting Professional Modifier None Typical Low $3.09 Median $37.15 Typical High $39.81 | Professional | None | $3.09 | $37.15 | $39.81 |
Midlands Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $46.77 | Professional | None | $3.47 | $3.47 | $46.77 |
United Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $39.81 | Professional | None | $37.15 | $37.15 | $39.81 |
Wellmark Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
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 $22.39 Median $22.39 Typical High $22.39 | Facility | 52 · Reduced service | $22.39 | $22.39 | $22.39 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.91 Median $8.91 Typical High $8.91 | Facility | 53 · Discontinued | $8.91 | $8.91 | $8.91 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $6.76 | Facility | 55 · Aftercare only | $6.76 | $6.76 | $6.76 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.47 Median $4.47 Typical High $4.47 | Facility | 56 · Pre-op care only | $4.47 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $19.05 Typical High $22.39 | Professional | 52 · Reduced service | $18.20 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.59 Typical High $8.91 | Professional | 53 · Discontinued | $7.24 | $7.59 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.75 Typical High $6.76 | Professional | 55 · Aftercare only | $5.37 | $5.75 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.80 Typical High $4.47 | Professional | 56 · Pre-op care only | $3.63 | $3.80 | $4.47 |
Where Iowa sits
The same service costs 20.4 times more in Arizona than in Hawaii. 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· 39th of 51
$37.15
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.