How much rates vary
Facilitymedian $60 · 10th to 90th $60 to $74Professionalmedian $63 · 10th to 90th $55 to $117
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 $74.13 Median $74.13 Typical High $125.89 | Facility | None | $74.13 | $74.13 | $125.89 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $74.13 | Professional | None | $57.54 | $57.54 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
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 $42.66 Median $61.66 Typical High $131.83 | Professional | None | $42.66 | $61.66 | $131.83 |
Medica Setting Facility Modifier None Typical Low $54.95 Median $63.10 Typical High $81.28 | Facility | None | $54.95 | $63.10 | $81.28 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $63.10 Typical High $229.09 | Professional | None | $54.95 | $63.10 | $229.09 |
Midlands Setting Professional Modifier None Typical Low $64.57 Median $66.07 Typical High $81.28 | Professional | None | $64.57 | $66.07 | $81.28 |
Midlands Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $114.82 | Professional | None | $64.57 | $64.57 | $114.82 |
Oscar Health Setting Professional Modifier None Typical Low $58.88 Median $97.72 Typical High $117.49 | Professional | None | $58.88 | $97.72 | $117.49 |
United Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
United Setting Professional Modifier None Typical Low $54.95 Median $57.54 Typical High $66.07 | Professional | None | $54.95 | $57.54 | $66.07 |
Wellmark Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Wellmark Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $28.84 Median $37.15 Typical High $41.69 | Facility | 52 · Reduced service | $28.84 | $37.15 | $41.69 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.48 Median $15.14 Typical High $16.60 | Facility | 53 · Discontinued | $11.48 | $15.14 | $16.60 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.51 Median $11.22 Typical High $12.59 | Facility | 55 · Aftercare only | $8.51 | $11.22 | $12.59 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.75 Median $7.41 Typical High $8.32 | Facility | 56 · Pre-op care only | $5.75 | $7.41 | $8.32 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $28.84 Typical High $37.15 | Professional | 52 · Reduced service | $28.84 | $28.84 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $15.14 | Professional | 53 · Discontinued | $11.48 | $11.48 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $11.22 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $7.41 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $7.41 |
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· 6th of 51
$63.10
AK $70.79NJ $57.54
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.