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 $60.26 Median $66.07 Typical High $85.11 | Facility | None | $60.26 | $66.07 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | None | $60.26 | $60.26 | $66.07 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $67.61 Typical High $77.62 | Professional | None | $60.26 | $67.61 | $77.62 |
Hally Health Setting Professional Modifier None Typical Low $42.66 Median $56.23 Typical High $112.20 | Professional | None | $42.66 | $56.23 | $112.20 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $61.66 Typical High $79.43 | Facility | None | $51.29 | $61.66 | $79.43 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $67.61 | Professional | None | $54.95 | $61.66 | $67.61 |
Midlands Setting Professional Modifier None Typical Low $61.66 Median $67.61 Typical High $83.18 | Professional | None | $61.66 | $67.61 | $83.18 |
Midlands Setting Professional Modifier None Typical Low $61.66 Median $69.18 Typical High $93.33 | Professional | None | $61.66 | $69.18 | $93.33 |
Oscar Health Setting Professional Modifier None Typical Low $60.26 Median $97.72 Typical High $120.23 | Professional | None | $60.26 | $97.72 | $120.23 |
United Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $56.23 Median $58.88 Typical High $67.61 | Professional | None | $56.23 | $58.88 | $67.61 |
Wellmark Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Wellmark Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
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 $30.20 Median $33.11 Typical High $42.66 | Facility | 52 · Reduced service | $30.20 | $33.11 | $42.66 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.02 Median $13.18 Typical High $16.98 | Facility | 53 · Discontinued | $12.02 | $13.18 | $16.98 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.12 Median $10.00 Typical High $12.59 | Facility | 55 · Aftercare only | $9.12 | $10.00 | $12.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.61 Typical High $8.51 | Facility | 56 · Pre-op care only | $6.03 | $6.61 | $8.51 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $30.20 Median $30.20 Typical High $33.11 | Professional | 52 · Reduced service | $30.20 | $30.20 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $12.02 Typical High $13.18 | Professional | 53 · Discontinued | $12.02 | $12.02 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $10.00 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.03 Typical High $6.61 | Professional | 56 · Pre-op care only | $6.03 | $6.03 | $6.61 |
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· 12th of 51
$61.66
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.