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 $28.84 Typical High $29.51 | Facility | None | $28.84 | $28.84 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $29.51 Typical High $29.51 | Professional | None | $28.84 | $29.51 | $29.51 |
Cigna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $44.67 | Professional | None | $19.50 | $19.50 | $44.67 |
Hally Health Setting Professional Modifier None Typical Low $23.44 Median $31.62 Typical High $100.00 | Professional | None | $23.44 | $31.62 | $100.00 |
Medica Setting Facility Modifier None Typical Low $15.14 Median $28.84 Typical High $43.65 | Facility | None | $15.14 | $28.84 | $43.65 |
Medica Setting Professional Modifier None Typical Low $15.14 Median $30.90 Typical High $43.65 | Professional | None | $15.14 | $30.90 | $43.65 |
Midlands Setting Professional Modifier None Typical Low $17.38 Median $19.50 Typical High $44.67 | Professional | None | $17.38 | $19.50 | $44.67 |
Midlands Setting Professional Modifier None Typical Low $18.20 Median $44.67 Typical High $66.07 | Professional | None | $18.20 | $44.67 | $66.07 |
United Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $36.31 | Professional | None | $30.90 | $32.36 | $36.31 |
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 $14.45 Typical High $14.79 | Facility | 52 · Reduced service | $14.45 | $14.45 | $14.79 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $5.89 | Facility | 53 · Discontinued | $5.75 | $5.75 | $5.89 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.37 Median $4.37 Typical High $4.47 | Facility | 55 · Aftercare only | $4.37 | $4.37 | $4.47 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.88 Typical High $2.95 | Facility | 56 · Pre-op care only | $2.88 | $2.88 | $2.95 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.45 Median $14.79 Typical High $14.79 | Professional | 52 · Reduced service | $14.45 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.89 Typical High $5.89 | Professional | 53 · Discontinued | $5.75 | $5.89 | $5.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $4.47 Typical High $4.47 | Professional | 55 · Aftercare only | $4.37 | $4.47 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $2.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $2.88 | $2.95 | $2.95 |
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· 50th of 51
$30.90
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.