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 $74.13 Median $97.72 Typical High $112.20 | Facility | None | $74.13 | $97.72 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $97.72 | Professional | None | $72.44 | $72.44 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $89.13 Typical High $95.50 | Professional | None | $74.13 | $89.13 | $95.50 |
Hally Health Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $295.12 | Professional | None | $69.18 | $128.82 | $295.12 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $97.72 Typical High $173.78 | Facility | None | $67.61 | $97.72 | $173.78 |
Medica Setting Professional Modifier None Typical Low $33.11 Median $83.18 Typical High $141.25 | Professional | None | $33.11 | $83.18 | $141.25 |
Midlands Setting Professional Modifier None Typical Low $83.18 Median $89.13 Typical High $89.13 | Professional | None | $83.18 | $89.13 | $89.13 |
United Setting Professional Modifier None Typical Low $29.51 Median $74.13 Typical High $125.89 | Professional | None | $29.51 | $74.13 | $125.89 |
Wellmark Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Facility | None | $74.13 | $74.13 | $74.13 |
Wellmark Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
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 $37.15 Median $48.98 Typical High $54.95 | Facility | 52 · Reduced service | $37.15 | $48.98 | $54.95 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $14.79 Median $19.50 Typical High $22.39 | Facility | 53 · Discontinued | $14.79 | $19.50 | $22.39 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $10.96 Median $14.79 Typical High $16.60 | Facility | 55 · Aftercare only | $10.96 | $14.79 | $16.60 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.77 Typical High $11.22 | Facility | 56 · Pre-op care only | $7.41 | $9.77 | $11.22 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $36.31 Median $36.31 Typical High $48.98 | Professional | 52 · Reduced service | $36.31 | $36.31 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $19.50 | Professional | 53 · Discontinued | $14.45 | $14.45 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $14.79 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $9.77 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $9.77 |
Where Iowa sits
The same service costs 1.6 times more in Hawaii than in Delaware. 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· 20th of 51
$75.86
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.