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 $47.86 Median $47.86 Typical High $47.86 | Facility | None | $47.86 | $47.86 | $47.86 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $47.86 Typical High $47.86 | Professional | None | $35.48 | $47.86 | $47.86 |
Cigna Setting Professional Modifier None Typical Low $7.94 Median $9.77 Typical High $75.86 | Professional | None | $7.94 | $9.77 | $75.86 |
Hally Health Setting Professional Modifier None Typical Low $13.18 Median $36.31 Typical High $36.31 | Professional | None | $13.18 | $36.31 | $36.31 |
Medica Setting Facility Modifier None Typical Low $9.33 Median $10.00 Typical High $81.28 | Facility | None | $9.33 | $10.00 | $81.28 |
Medica Setting Professional Modifier None Typical Low $10.96 Median $46.77 Typical High $48.98 | Professional | None | $10.96 | $46.77 | $48.98 |
Midlands Setting Professional Modifier None Typical Low $10.23 Median $10.23 Typical High $85.11 | Professional | None | $10.23 | $10.23 | $85.11 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $38.90 | Professional | None | $36.31 | $36.31 | $38.90 |
Wellmark Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
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 $23.99 Median $23.99 Typical High $23.99 | Facility | 52 · Reduced service | $23.99 | $23.99 | $23.99 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $9.55 Median $9.55 Typical High $9.55 | Facility | 53 · Discontinued | $9.55 | $9.55 | $9.55 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $7.24 | Facility | 55 · Aftercare only | $7.24 | $7.24 | $7.24 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.79 Median $4.79 Typical High $4.79 | Facility | 56 · Pre-op care only | $4.79 | $4.79 | $4.79 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $17.38 Median $23.44 Typical High $23.99 | Professional | 52 · Reduced service | $17.38 | $23.44 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $9.55 Typical High $9.55 | Professional | 53 · Discontinued | $7.08 | $9.55 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $7.08 Typical High $7.24 | Professional | 55 · Aftercare only | $5.25 | $7.08 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.68 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.55 | $4.68 | $4.79 |
Where Iowa sits
The same service costs 8.1 times more in Kansas 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· 20th of 51
$37.15
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.