How much rates vary
Facilitymedian $83 · 10th to 90th $76 to $91Professionalmedian $83 · 10th to 90th $74 to $112
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 $75.86 Median $91.20 Typical High $114.82 | Facility | None | $75.86 | $91.20 | $114.82 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $91.20 | Professional | None | $75.86 | $75.86 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $91.20 Typical High $97.72 | Professional | None | $75.86 | $91.20 | $97.72 |
Hally Health Setting Professional Modifier None Typical Low $54.95 Median $85.11 Typical High $177.83 | Professional | None | $54.95 | $85.11 | $177.83 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $89.13 Typical High $112.20 | Facility | None | $74.13 | $89.13 | $112.20 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $104.71 | Professional | None | $74.13 | $87.10 | $104.71 |
Midlands Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $112.20 | Professional | None | $91.20 | $91.20 | $112.20 |
Midlands Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $162.18 | Professional | None | $91.20 | $114.82 | $162.18 |
Oscar Health Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $162.18 | Professional | None | $81.28 | $134.90 | $162.18 |
United Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
United Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $89.13 | Professional | None | $75.86 | $79.43 | $89.13 |
Wellmark Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Wellmark Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | None | $83.18 | $83.18 | $83.18 |
10 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 $38.02 Median $45.71 Typical High $57.54 | Facility | 52 · Reduced service | $38.02 | $45.71 | $57.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $15.14 Median $18.20 Typical High $22.91 | Facility | 53 · Discontinued | $15.14 | $18.20 | $22.91 |
Aetna Setting Facility Modifier 54 · Surgery only Typical Low $57.54 Median $69.18 Typical High $85.11 | Facility | 54 · Surgery only | $57.54 | $69.18 | $85.11 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $11.48 Median $13.80 Typical High $16.98 | Facility | 55 · Aftercare only | $11.48 | $13.80 | $16.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.12 Typical High $11.48 | Facility | 56 · Pre-op care only | $7.59 | $9.12 | $11.48 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.02 Median $38.02 Typical High $45.71 | Professional | 52 · Reduced service | $38.02 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $15.14 Typical High $18.20 | Professional | 53 · Discontinued | $15.14 | $15.14 | $18.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $57.54 Typical High $69.18 | Professional | 54 · Surgery only | $57.54 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $11.48 Typical High $13.80 | Professional | 55 · Aftercare only | $11.48 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $7.59 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.59 | $7.59 | $9.12 |
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· 8th of 51
$83.18
AK $93.33NJ $75.86
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.