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 $56.23 Median $57.54 Typical High $83.18 | Facility | None | $56.23 | $57.54 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $58.88 | Professional | None | $56.23 | $56.23 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $66.07 Typical High $72.44 | Professional | None | $57.54 | $66.07 | $72.44 |
Hally Health Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $100.00 | Professional | None | $50.12 | $54.95 | $100.00 |
Medica Setting Facility Modifier None Typical Low $33.11 Median $64.57 Typical High $69.18 | Facility | None | $33.11 | $64.57 | $69.18 |
Medica Setting Professional Modifier None Typical Low $21.88 Median $54.95 Typical High $91.20 | Professional | None | $21.88 | $54.95 | $91.20 |
Midlands Setting Professional Modifier None Typical Low $66.07 Median $66.07 Typical High $72.44 | Professional | None | $66.07 | $66.07 | $72.44 |
United Setting Professional Modifier None Typical Low $21.88 Median $54.95 Typical High $75.86 | Professional | None | $21.88 | $54.95 | $75.86 |
Wellmark Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Wellmark Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
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 $28.18 Median $28.84 Typical High $41.69 | Facility | 52 · Reduced service | $28.18 | $28.84 | $41.69 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $16.60 | Facility | 53 · Discontinued | $11.48 | $11.48 | $16.60 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $12.59 | Facility | 55 · Aftercare only | $8.51 | $8.51 | $12.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.75 Typical High $8.32 | Facility | 56 · Pre-op care only | $5.62 | $5.75 | $8.32 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.18 Typical High $29.51 | Professional | 52 · Reduced service | $28.18 | $28.18 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $11.75 | Professional | 53 · Discontinued | $11.48 | $11.48 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $8.71 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $5.89 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $5.89 |
Where Iowa sits
The same service costs 1.6 times more in Alaska than in Louisiana. 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· 42nd of 51
$54.95
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.