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 $660.69 Median $1,819.70 Typical High $1,819.70 | Facility | None | $660.69 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier None Typical Low $562.34 Median $1,000.00 Typical High $1,819.70 | Professional | None | $562.34 | $1,000.00 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $794.33 | Professional | None | $575.44 | $724.44 | $794.33 |
Hally Health Setting Professional Modifier None Typical Low $630.96 Median $1,096.48 Typical High $2,884.03 | Professional | None | $630.96 | $1,096.48 | $2,884.03 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $794.33 Typical High $1,819.70 | Facility | None | $524.81 | $794.33 | $1,819.70 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $549.54 Typical High $1,819.70 | Professional | None | $524.81 | $549.54 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $870.96 | Professional | None | $741.31 | $741.31 | $870.96 |
United Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $562.34 | Facility | None | $562.34 | $562.34 | $562.34 |
United Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $691.83 | Professional | None | $660.69 | $660.69 | $691.83 |
Wellmark Setting Facility Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
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 $331.13 Median $891.25 Typical High $891.25 | Facility | 52 · Reduced service | $331.13 | $891.25 | $891.25 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $131.83 Median $363.08 Typical High $363.08 | Facility | 53 · Discontinued | $131.83 | $363.08 | $363.08 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $97.72 Median $269.15 Typical High $269.15 | Facility | 55 · Aftercare only | $97.72 | $269.15 | $269.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $66.07 Median $181.97 Typical High $181.97 | Facility | 56 · Pre-op care only | $66.07 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $281.84 Median $489.78 Typical High $891.25 | Professional | 52 · Reduced service | $281.84 | $489.78 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $199.53 Typical High $363.08 | Professional | 53 · Discontinued | $112.20 | $199.53 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $147.91 Typical High $269.15 | Professional | 55 · Aftercare only | $85.11 | $147.91 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $100.00 Typical High $181.97 | Professional | 56 · Pre-op care only | $56.23 | $100.00 | $181.97 |
Where Iowa sits
The same service costs 2.7 times more in Wyoming than in Georgia. 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· 36th of 51
$661
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.