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 $295.12 Median $602.56 Typical High $602.56 | Facility | None | $295.12 | $602.56 | $602.56 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $323.59 Typical High $602.56 | Professional | None | $295.12 | $323.59 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $302.00 Typical High $380.19 | Professional | None | $117.49 | $302.00 | $380.19 |
Hally Health Setting Professional Modifier None Typical Low $2.69 Median $295.12 Typical High $302.00 | Professional | None | $2.69 | $295.12 | $302.00 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $218.78 Typical High $602.56 | Facility | None | $67.61 | $218.78 | $602.56 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $194.98 Typical High $275.42 | Professional | None | $87.10 | $194.98 | $275.42 |
Midlands Setting Professional Modifier None Typical Low $117.49 Median $446.68 Typical High $446.68 | Professional | None | $117.49 | $446.68 | $446.68 |
United Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
United Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $229.09 | Professional | None | $213.80 | $213.80 | $229.09 |
Wellmark Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $213.80 | Facility | None | $213.80 | $213.80 | $213.80 |
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 $147.91 Median $302.00 Typical High $302.00 | Facility | 52 · Reduced service | $147.91 | $302.00 | $302.00 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $58.88 Median $120.23 Typical High $120.23 | Facility | 53 · Discontinued | $58.88 | $120.23 | $120.23 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $44.67 Median $89.13 Typical High $89.13 | Facility | 55 · Aftercare only | $44.67 | $89.13 | $89.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $29.51 Median $60.26 Typical High $60.26 | Facility | 56 · Pre-op care only | $29.51 | $60.26 | $60.26 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $147.91 Median $162.18 Typical High $302.00 | Professional | 52 · Reduced service | $147.91 | $162.18 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $64.57 Typical High $120.23 | Professional | 53 · Discontinued | $58.88 | $64.57 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $48.98 Typical High $89.13 | Professional | 55 · Aftercare only | $44.67 | $48.98 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $32.36 Typical High $60.26 | Professional | 56 · Pre-op care only | $29.51 | $32.36 | $60.26 |
Where Iowa sits
The same service costs 6.8 times more in Wyoming 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· 47th 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.