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 $28.84 Median $69.18 Typical High $69.18 | Facility | None | $28.84 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $69.18 | Professional | None | $28.84 | $28.84 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $29.51 Typical High $57.54 | Professional | None | $28.84 | $29.51 | $57.54 |
Hally Health Setting Professional Modifier None Typical Low $21.88 Median $39.81 Typical High $147.91 | Professional | None | $21.88 | $39.81 | $147.91 |
Medica Setting Facility Modifier None Typical Low $19.95 Median $30.90 Typical High $70.79 | Facility | None | $19.95 | $30.90 | $70.79 |
Medica Setting Professional Modifier None Typical Low $19.95 Median $23.44 Typical High $56.23 | Professional | None | $19.95 | $23.44 | $56.23 |
Midlands Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $57.54 | Professional | None | $29.51 | $29.51 | $57.54 |
Midlands Setting Professional Modifier None Typical Low $34.67 Median $57.54 Typical High $79.43 | Professional | None | $34.67 | $57.54 | $79.43 |
Oscar Health Setting Professional Modifier None Typical Low $26.92 Median $43.65 Typical High $56.23 | Professional | None | $26.92 | $43.65 | $56.23 |
United Setting Professional Modifier None Typical Low $24.55 Median $26.30 Typical High $29.51 | Professional | None | $24.55 | $26.30 | $29.51 |
Wellmark Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
Wellmark Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
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 $14.45 Median $34.67 Typical High $34.67 | Facility | 52 · Reduced service | $14.45 | $34.67 | $34.67 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.75 Median $13.80 Typical High $13.80 | Facility | 53 · Discontinued | $5.75 | $13.80 | $13.80 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.37 Median $10.47 Typical High $10.47 | Facility | 55 · Aftercare only | $4.37 | $10.47 | $10.47 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.88 Median $6.92 Typical High $6.92 | Facility | 56 · Pre-op care only | $2.88 | $6.92 | $6.92 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $14.45 Typical High $34.67 | Professional | 52 · Reduced service | $14.45 | $14.45 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $13.80 | Professional | 53 · Discontinued | $5.75 | $5.75 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $10.47 | Professional | 55 · Aftercare only | $4.37 | $4.37 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $6.92 | Professional | 56 · Pre-op care only | $2.88 | $2.88 | $6.92 |
Where Iowa sits
The same service costs 2.8 times more in Wyoming than in Arizona. 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· 22nd of 51
$28.84
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.