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 $616.60 Median $616.60 Typical High $616.60 | Facility | None | $616.60 | $616.60 | $616.60 |
Aetna Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $616.60 | Professional | None | $524.81 | $562.34 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $630.96 Typical High $676.08 | Professional | None | $537.03 | $630.96 | $676.08 |
Hally Health Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $1,000.00 | Professional | None | $380.19 | $524.81 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $537.03 Median $630.96 Typical High $741.31 | Facility | None | $537.03 | $630.96 | $741.31 |
Medica Setting Professional Modifier None Typical Low $537.03 Median $549.54 Typical High $1,288.25 | Professional | None | $537.03 | $549.54 | $1,288.25 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $691.83 Typical High $691.83 | Professional | None | $645.65 | $691.83 | $691.83 |
United Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
United Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $562.34 | Professional | None | $524.81 | $524.81 | $562.34 |
Wellmark Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $524.81 | Facility | None | $524.81 | $524.81 | $524.81 |
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 $309.03 Median $309.03 Typical High $309.03 | Facility | 52 · Reduced service | $309.03 | $309.03 | $309.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | 53 · Discontinued | $123.03 | $123.03 | $123.03 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | 55 · Aftercare only | $93.33 | $93.33 | $93.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | 56 · Pre-op care only | $61.66 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $263.03 Median $275.42 Typical High $309.03 | Professional | 52 · Reduced service | $263.03 | $275.42 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $107.15 Median $112.20 Typical High $123.03 | Professional | 53 · Discontinued | $107.15 | $112.20 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $83.18 Typical High $93.33 | Professional | 55 · Aftercare only | $79.43 | $83.18 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $56.23 Typical High $61.66 | Professional | 56 · Pre-op care only | $52.48 | $56.23 | $61.66 |
Where Iowa sits
The same service costs 1.9 times more in Alaska than in Virginia. 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· 18th of 51
$537
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.