How much rates vary
Facilitymedian $178 · 10th to 90th $174 to $204Professionalmedian $182 · 10th to 90th $162 to $219
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 $173.78 Median $204.17 Typical High $245.47 | Facility | None | $173.78 | $204.17 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $204.17 | Professional | None | $173.78 | $173.78 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $213.80 | Professional | None | $173.78 | $194.98 | $213.80 |
Hally Health Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $354.81 | Professional | None | $117.49 | $173.78 | $354.81 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $181.97 Typical High $234.42 | Facility | None | $162.18 | $181.97 | $234.42 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $181.97 Typical High $199.53 | Professional | None | $162.18 | $181.97 | $199.53 |
Midlands Setting Professional Modifier None Typical Low $186.21 Median $194.98 Typical High $245.47 | Professional | None | $186.21 | $194.98 | $245.47 |
Midlands Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $269.15 | Professional | None | $186.21 | $213.80 | $269.15 |
Oscar Health Setting Professional Modifier None Typical Low $177.83 Median $288.40 Typical High $346.74 | Professional | None | $177.83 | $288.40 | $346.74 |
United Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $173.78 | Facility | None | $173.78 | $173.78 | $173.78 |
United Setting Professional Modifier None Typical Low $162.18 Median $173.78 Typical High $194.98 | Professional | None | $162.18 | $173.78 | $194.98 |
Wellmark Setting Facility Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Wellmark Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $177.83 | Professional | None | $177.83 | $177.83 | $177.83 |
10 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 $87.10 Median $100.00 Typical High $123.03 | Facility | 52 · Reduced service | $87.10 | $100.00 | $123.03 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $34.67 Median $40.74 Typical High $48.98 | Facility | 53 · Discontinued | $34.67 | $40.74 | $48.98 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $128.82 Median $151.36 Typical High $186.21 | Facility | 54 · Surgery only | $128.82 | $151.36 | $186.21 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $25.70 Median $30.20 Typical High $37.15 | Facility | 55 · Aftercare only | $25.70 | $30.20 | $37.15 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $17.38 Median $20.42 Typical High $24.55 | Facility | 56 · Pre-op care only | $17.38 | $20.42 | $24.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $87.10 Median $87.10 Typical High $100.00 | Professional | 52 · Reduced service | $87.10 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $34.67 Median $34.67 Typical High $40.74 | Professional | 53 · Discontinued | $34.67 | $34.67 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $151.36 | Professional | 54 · Surgery only | $128.82 | $128.82 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $17.38 Typical High $20.42 | Professional | 56 · Pre-op care only | $17.38 | $17.38 | $20.42 |
Where Iowa sits
Rates are fairly even across states for this service. 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· 7th of 51
$182
AK $214AZ $166
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.