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 $42.66 Median $42.66 Typical High $134.90 | Facility | None | $42.66 | $42.66 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $60.26 Typical High $60.26 | Professional | None | $42.66 | $60.26 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $53.70 Typical High $67.61 | Professional | None | $30.90 | $53.70 | $67.61 |
Hally Health Setting Professional Modifier None Typical Low $89.13 Median $91.20 Typical High $138.04 | Professional | None | $89.13 | $91.20 | $138.04 |
Medica Setting Facility Modifier None Typical Low $30.20 Median $61.66 Typical High $102.33 | Facility | None | $30.20 | $61.66 | $102.33 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $38.02 Typical High $141.25 | Professional | None | $37.15 | $38.02 | $141.25 |
Midlands Setting Professional Modifier None Typical Low $30.90 Median $69.18 Typical High $69.18 | Professional | None | $30.90 | $69.18 | $69.18 |
United Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $69.18 | Professional | None | $63.10 | $63.10 | $69.18 |
Wellmark Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
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 $20.89 Median $20.89 Typical High $30.20 | Facility | 52 · Reduced service | $20.89 | $20.89 | $30.20 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $12.02 | Facility | 53 · Discontinued | $8.51 | $8.51 | $12.02 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.31 Median $6.31 Typical High $9.12 | Facility | 55 · Aftercare only | $6.31 | $6.31 | $9.12 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $6.03 | Facility | 56 · Pre-op care only | $4.27 | $4.27 | $6.03 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $20.89 Median $25.12 Typical High $30.20 | Professional | 52 · Reduced service | $20.89 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $10.00 Typical High $12.02 | Professional | 53 · Discontinued | $8.51 | $10.00 | $12.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.59 Typical High $9.12 | Professional | 55 · Aftercare only | $6.31 | $7.59 | $9.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $5.01 Typical High $6.03 | Professional | 56 · Pre-op care only | $4.27 | $5.01 | $6.03 |
Where Iowa sits
The same service costs 3.0 times more in Kansas than in South Carolina. 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· 50th of 51
$48.98
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.