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 $158.49 Median $158.49 Typical High $158.49 | Facility | None | $158.49 | $158.49 | $158.49 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $158.49 Typical High $158.49 | Professional | None | $154.88 | $158.49 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $158.49 | Professional | None | $53.70 | $67.61 | $158.49 |
Hally Health Setting Professional Modifier None Typical Low $77.62 Median $147.91 Typical High $1,513.56 | Professional | None | $77.62 | $147.91 | $1,513.56 |
Medica Setting Facility Modifier None Typical Low $48.98 Median $56.23 Typical High $177.83 | Facility | None | $48.98 | $56.23 | $177.83 |
Medica Setting Professional Modifier None Typical Low $61.66 Median $154.88 Typical High $165.96 | Professional | None | $61.66 | $154.88 | $165.96 |
Midlands Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $181.97 | Professional | None | $57.54 | $57.54 | $181.97 |
United Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $169.82 | Professional | None | $158.49 | $158.49 | $169.82 |
Wellmark Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
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 $79.43 Median $79.43 Typical High $79.43 | Facility | 52 · Reduced service | $79.43 | $79.43 | $79.43 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | 53 · Discontinued | $32.36 | $32.36 | $32.36 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $23.99 Median $23.99 Typical High $23.99 | Facility | 55 · Aftercare only | $23.99 | $23.99 | $23.99 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $15.85 Median $15.85 Typical High $15.85 | Facility | 56 · Pre-op care only | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $77.62 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $77.62 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $32.36 Typical High $32.36 | Professional | 53 · Discontinued | $30.90 | $32.36 | $32.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $22.91 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $15.49 | $15.85 | $15.85 |
Where Iowa sits
The same service costs 4.4 times more in Alaska 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· 42nd of 51
$155
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.