How much rates vary
Facilitymedian $40 · 10th to 90th $37 to $56Professionalmedian $44 · 10th to 90th $36 to $105
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 $54.95 Median $56.23 Typical High $72.44 | Facility | None | $54.95 | $56.23 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $56.23 | Professional | None | $36.31 | $36.31 | $56.23 |
Cigna Setting Facility Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $43.65 Typical High $51.29 | Professional | None | $36.31 | $43.65 | $51.29 |
Hally Health Setting Professional Modifier None Typical Low $34.67 Median $53.70 Typical High $131.83 | Professional | None | $34.67 | $53.70 | $131.83 |
Medica Setting Facility Modifier None Typical Low $37.15 Median $44.67 Typical High $56.23 | Facility | None | $37.15 | $44.67 | $56.23 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $44.67 Typical High $165.96 | Professional | None | $37.15 | $44.67 | $165.96 |
Midlands Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $54.95 | Professional | None | $43.65 | $43.65 | $54.95 |
Midlands Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $104.71 | Professional | None | $50.12 | $51.29 | $104.71 |
Oscar Health Setting Professional Modifier None Typical Low $38.90 Median $64.57 Typical High $79.43 | Professional | None | $38.90 | $64.57 | $79.43 |
United Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
United Setting Professional Modifier None Typical Low $36.31 Median $38.02 Typical High $43.65 | Professional | None | $36.31 | $38.02 | $43.65 |
Wellmark Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Wellmark Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
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 $18.20 Median $28.18 Typical High $28.18 | Facility | 52 · Reduced service | $18.20 | $28.18 | $28.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.24 Median $11.22 Typical High $11.22 | Facility | 53 · Discontinued | $7.24 | $11.22 | $11.22 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.50 Median $8.51 Typical High $8.51 | Facility | 55 · Aftercare only | $5.50 | $8.51 | $8.51 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.63 Median $5.62 Typical High $5.62 | Facility | 56 · Pre-op care only | $3.63 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $18.20 Typical High $28.18 | Professional | 52 · Reduced service | $18.20 | $18.20 | $28.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $11.22 | Professional | 53 · Discontinued | $7.24 | $7.24 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $8.51 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $5.62 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $5.62 |
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· 4th of 51
$43.65
AK $50.12GA $36.31
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.