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 $11.75 Median $50.12 Typical High $50.12 | Facility | None | $11.75 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $12.30 Median $12.30 Typical High $50.12 | Professional | None | $12.30 | $12.30 | $50.12 |
Cigna Setting Professional Modifier None Typical Low $9.33 Median $12.59 Typical High $31.62 | Professional | None | $9.33 | $12.59 | $31.62 |
Hally Health Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $91.20 | Professional | None | $16.22 | $16.22 | $91.20 |
Medica Setting Facility Modifier None Typical Low $17.78 Median $20.89 Typical High $100.00 | Facility | None | $17.78 | $20.89 | $100.00 |
Medica Setting Professional Modifier None Typical Low $5.75 Median $14.79 Typical High $54.95 | Professional | None | $5.75 | $14.79 | $54.95 |
Midlands Setting Professional Modifier None Typical Low $9.33 Median $9.33 Typical High $16.22 | Professional | None | $9.33 | $9.33 | $16.22 |
United Setting Professional Modifier None Typical Low $3.09 Median $7.76 Typical High $13.18 | Professional | None | $3.09 | $7.76 | $13.18 |
Wellmark Setting Facility Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Facility | None | $7.76 | $7.76 | $7.76 |
Wellmark Setting Professional Modifier None Typical Low $7.76 Median $7.76 Typical High $7.76 | Professional | None | $7.76 | $7.76 | $7.76 |
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 $5.89 Median $25.12 Typical High $25.12 | Facility | 52 · Reduced service | $5.89 | $25.12 | $25.12 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $2.34 Median $10.00 Typical High $10.00 | Facility | 53 · Discontinued | $2.34 | $10.00 | $10.00 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $1.78 Median $7.41 Typical High $7.41 | Facility | 55 · Aftercare only | $1.78 | $7.41 | $7.41 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $1.17 Median $5.01 Typical High $5.01 | Facility | 56 · Pre-op care only | $1.17 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $6.17 Median $6.17 Typical High $25.12 | Professional | 52 · Reduced service | $6.17 | $6.17 | $25.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.45 Median $2.45 Typical High $10.00 | Professional | 53 · Discontinued | $2.45 | $2.45 | $10.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.86 Median $1.86 Typical High $7.41 | Professional | 55 · Aftercare only | $1.86 | $1.86 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.23 Median $1.23 Typical High $5.01 | Professional | 56 · Pre-op care only | $1.23 | $1.23 | $5.01 |
Where Iowa sits
The same service costs 6.3 times more in Wyoming than in Rhode Island. 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· 44th of 51
$12.30
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.