How much rates vary
Facilitymedian $355 · 10th to 90th $331 to $389Professionalmedian $372 · 10th to 90th $324 to $692
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 $331.13 Median $380.19 Typical High $489.78 | Facility | None | $331.13 | $380.19 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $380.19 | Professional | None | $331.13 | $331.13 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $416.87 | Professional | None | $331.13 | $389.05 | $416.87 |
Hally Health Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $707.95 | Professional | None | $316.23 | $446.68 | $707.95 |
Medica Setting Facility Modifier None Typical Low $316.23 Median $371.54 Typical High $478.63 | Facility | None | $316.23 | $371.54 | $478.63 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $1,380.38 | Professional | None | $316.23 | $371.54 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $478.63 | Professional | None | $389.05 | $389.05 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $741.31 | Professional | None | $398.11 | $398.11 | $741.31 |
Oscar Health Setting Professional Modifier None Typical Low $346.74 Median $575.44 Typical High $691.83 | Professional | None | $346.74 | $575.44 | $691.83 |
United Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $331.13 | Facility | None | $331.13 | $331.13 | $331.13 |
United Setting Professional Modifier None Typical Low $323.59 Median $338.84 Typical High $380.19 | Professional | None | $323.59 | $338.84 | $380.19 |
Wellmark Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Facility | None | $354.81 | $354.81 | $354.81 |
Wellmark Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $354.81 | Professional | None | $354.81 | $354.81 | $354.81 |
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 $165.96 Median $190.55 Typical High $245.47 | Facility | 52 · Reduced service | $165.96 | $190.55 | $245.47 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $66.07 Median $75.86 Typical High $97.72 | Facility | 53 · Discontinued | $66.07 | $75.86 | $97.72 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $48.98 Median $57.54 Typical High $72.44 | Facility | 55 · Aftercare only | $48.98 | $57.54 | $72.44 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.02 Typical High $48.98 | Facility | 56 · Pre-op care only | $33.11 | $38.02 | $48.98 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $165.96 Median $165.96 Typical High $190.55 | Professional | 52 · Reduced service | $165.96 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $66.07 Typical High $75.86 | Professional | 53 · Discontinued | $66.07 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $48.98 Typical High $57.54 | Professional | 55 · Aftercare only | $48.98 | $48.98 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $33.11 Typical High $38.02 | Professional | 56 · Pre-op care only | $33.11 | $33.11 | $38.02 |
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· 5th of 51
$372
AK $407VT $331
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.