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 $389.05 Median $467.74 Typical High $588.84 | Facility | None | $389.05 | $467.74 | $588.84 |
Aetna Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $467.74 | Professional | None | $389.05 | $389.05 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $501.19 | Professional | None | $398.11 | $398.11 | $501.19 |
Hally Health Setting Professional Modifier None Typical Low $346.74 Median $389.05 Typical High $478.63 | Professional | None | $346.74 | $389.05 | $478.63 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $478.63 Typical High $524.81 | Facility | None | $186.21 | $478.63 | $524.81 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $398.11 Typical High $512.86 | Professional | None | $158.49 | $398.11 | $512.86 |
Midlands Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $501.19 | Professional | None | $501.19 | $501.19 | $501.19 |
United Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
United Setting Professional Modifier None Typical Low $154.88 Median $389.05 Typical High $537.03 | Professional | None | $154.88 | $389.05 | $537.03 |
Wellmark Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Facility | None | $389.05 | $389.05 | $389.05 |
Wellmark Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
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 $194.98 Median $234.42 Typical High $295.12 | Facility | 52 · Reduced service | $194.98 | $234.42 | $295.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $77.62 Median $93.33 Typical High $117.49 | Facility | 53 · Discontinued | $77.62 | $93.33 | $117.49 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $58.88 Median $70.79 Typical High $89.13 | Facility | 55 · Aftercare only | $58.88 | $70.79 | $89.13 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $38.90 Median $46.77 Typical High $58.88 | Facility | 56 · Pre-op care only | $38.90 | $46.77 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $194.98 Median $194.98 Typical High $234.42 | Professional | 52 · Reduced service | $194.98 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $77.62 Typical High $93.33 | Professional | 53 · Discontinued | $77.62 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $58.88 Typical High $70.79 | Professional | 55 · Aftercare only | $58.88 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $38.90 Typical High $46.77 | Professional | 56 · Pre-op care only | $38.90 | $38.90 | $46.77 |
Where Iowa sits
The same service costs 1.7 times more in Alaska than in Oklahoma. 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· 40th of 51
$389
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.