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 $6.61 Median $21.88 Typical High $46.77 | Facility | None | $6.61 | $21.88 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $3.39 Median $10.23 Typical High $25.12 | Professional | None | $3.39 | $10.23 | $25.12 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $4.27 Typical High $13.80 | Professional | None | $3.39 | $4.27 | $13.80 |
Hally Health Setting Professional Modifier None Typical Low $5.01 Median $15.49 Typical High $109.65 | Professional | None | $5.01 | $15.49 | $109.65 |
Medica Setting Facility Modifier None Typical Low $6.76 Median $11.48 Typical High $54.95 | Facility | None | $6.76 | $11.48 | $54.95 |
Medica Setting Professional Modifier None Typical Low $5.25 Median $6.31 Typical High $57.54 | Professional | None | $5.25 | $6.31 | $57.54 |
Midlands Setting Professional Modifier None Typical Low $6.61 Median $6.61 Typical High $13.80 | Professional | None | $6.61 | $6.61 | $13.80 |
United Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $81.28 | Professional | None | $30.90 | $32.36 | $81.28 |
Wellmark Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
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 $10.96 Median $10.96 Typical High $23.44 | Facility | 52 · Reduced service | $10.96 | $10.96 | $23.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $4.37 Median $4.37 Typical High $9.33 | Facility | 53 · Discontinued | $4.37 | $4.37 | $9.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.31 Median $3.31 Typical High $6.92 | Facility | 55 · Aftercare only | $3.31 | $3.31 | $6.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.19 Median $2.19 Typical High $4.68 | Facility | 56 · Pre-op care only | $2.19 | $2.19 | $4.68 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $1.70 Median $10.96 Typical High $15.49 | Professional | 52 · Reduced service | $1.70 | $10.96 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.68 Median $4.37 Typical High $6.17 | Professional | 53 · Discontinued | $0.68 | $4.37 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.50 Median $3.31 Typical High $4.68 | Professional | 55 · Aftercare only | $0.50 | $3.31 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.34 Median $2.19 Typical High $3.09 | Professional | 56 · Pre-op care only | $0.34 | $2.19 | $3.09 |
Where Iowa sits
The same service costs 9.1 times more in Rhode Island than in Florida. 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· 11th of 51
$21.88
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.