How much rates vary
Facilitymedian $132 · 10th to 90th $120 to $240Professionalmedian $132 · 10th to 90th $105 to $240
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 $120.23 Median $239.88 Typical High $239.88 | Facility | None | $120.23 | $239.88 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $239.88 | Professional | None | $104.71 | $104.71 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $144.54 Typical High $165.96 | Professional | None | $104.71 | $144.54 | $165.96 |
Hally Health Setting Professional Modifier None Typical Low $95.50 Median $138.04 Typical High $1,122.02 | Professional | None | $95.50 | $138.04 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $162.18 Typical High $302.00 | Facility | None | $107.15 | $162.18 | $302.00 |
Medica Setting Professional Modifier None Typical Low $107.15 Median $128.82 Typical High $213.80 | Professional | None | $107.15 | $128.82 | $213.80 |
Midlands Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $302.00 | Professional | None | $144.54 | $144.54 | $302.00 |
Midlands Setting Professional Modifier None Typical Low $158.49 Median $302.00 Typical High $302.00 | Professional | None | $158.49 | $302.00 | $302.00 |
Oscar Health Setting Professional Modifier None Typical Low $93.33 Median $154.88 Typical High $257.04 | Professional | None | $93.33 | $154.88 | $257.04 |
United Setting Facility Modifier None Typical Low $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
United Setting Professional Modifier None Typical Low $120.23 Median $128.82 Typical High $144.54 | Professional | None | $120.23 | $128.82 | $144.54 |
Wellmark Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Wellmark Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
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 $60.26 Median $120.23 Typical High $120.23 | Facility | 52 · Reduced service | $60.26 | $120.23 | $120.23 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $23.99 Median $47.86 Typical High $47.86 | Facility | 53 · Discontinued | $23.99 | $47.86 | $47.86 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $18.20 Median $36.31 Typical High $36.31 | Facility | 55 · Aftercare only | $18.20 | $36.31 | $36.31 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $12.02 Median $23.99 Typical High $23.99 | Facility | 56 · Pre-op care only | $12.02 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $52.48 Median $52.48 Typical High $120.23 | Professional | 52 · Reduced service | $52.48 | $52.48 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $47.86 | Professional | 53 · Discontinued | $20.89 | $20.89 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $36.31 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $23.99 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $23.99 |
Where Iowa sits
The same service costs 1.9 times more in Wyoming than in Vermont. 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
$132
WY $204VT $105
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.