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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $89.13 Typical High $104.71 | Professional | None | $83.18 | $89.13 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $107.15 Typical High $117.49 | Professional | None | $95.50 | $107.15 | $117.49 |
Hally Health Setting Professional Modifier None Typical Low $138.04 Median $147.91 Typical High $169.82 | Professional | None | $138.04 | $147.91 | $169.82 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $102.33 Typical High $147.91 | Facility | None | $95.50 | $102.33 | $147.91 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $91.20 Typical High $204.17 | Professional | None | $87.10 | $91.20 | $204.17 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $107.15 | Professional | None | $104.71 | $104.71 | $107.15 |
United Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | None | $87.10 | $87.10 | $95.50 |
Wellmark Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
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 $52.48 Median $52.48 Typical High $52.48 | Facility | 52 · Reduced service | $52.48 | $52.48 | $52.48 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | 53 · Discontinued | $20.89 | $20.89 | $20.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $15.49 Median $15.49 Typical High $15.49 | Facility | 55 · Aftercare only | $15.49 | $15.49 | $15.49 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $10.47 | Facility | 56 · Pre-op care only | $10.47 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $41.69 Median $44.67 Typical High $52.48 | Professional | 52 · Reduced service | $41.69 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $17.78 Typical High $20.89 | Professional | 53 · Discontinued | $16.60 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $12.59 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.32 | $8.91 | $10.47 |
Where Iowa sits
The same service costs 1.6 times more in Alaska than in Texas. 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· 34th of 51
$89.13
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.