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 $26.30 Median $26.30 Typical High $26.30 | Facility | None | $26.30 | $26.30 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $26.30 | Professional | None | $21.38 | $21.38 | $26.30 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $23.99 Typical High $33.88 | Professional | None | $22.39 | $23.99 | $33.88 |
Hally Health Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $89.13 | Professional | None | $48.98 | $53.70 | $89.13 |
Medica Setting Facility Modifier None Typical Low $23.44 Median $28.18 Typical High $35.48 | Facility | None | $23.44 | $28.18 | $35.48 |
Medica Setting Professional Modifier None Typical Low $21.88 Median $28.18 Typical High $100.00 | Professional | None | $21.88 | $28.18 | $100.00 |
Midlands Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $33.88 | Professional | None | $32.36 | $32.36 | $33.88 |
Midlands Setting Professional Modifier None Typical Low $31.62 Median $32.36 Typical High $58.88 | Professional | None | $31.62 | $32.36 | $58.88 |
United Setting Facility Modifier None Typical Low $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
United Setting Professional Modifier None Typical Low $21.88 Median $22.91 Typical High $26.30 | Professional | None | $21.88 | $22.91 | $26.30 |
Wellmark Setting Facility Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Wellmark Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
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 $13.18 Median $13.18 Typical High $13.18 | Facility | 52 · Reduced service | $13.18 | $13.18 | $13.18 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.25 Median $5.25 Typical High $5.25 | Facility | 53 · Discontinued | $5.25 | $5.25 | $5.25 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $3.98 Median $3.98 Typical High $3.98 | Facility | 55 · Aftercare only | $3.98 | $3.98 | $3.98 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.63 Median $2.63 Typical High $2.63 | Facility | 56 · Pre-op care only | $2.63 | $2.63 | $2.63 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $10.47 Median $10.47 Typical High $13.18 | Professional | 52 · Reduced service | $10.47 | $10.47 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.27 Typical High $5.25 | Professional | 53 · Discontinued | $4.27 | $4.27 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.16 Typical High $3.98 | Professional | 55 · Aftercare only | $3.16 | $3.16 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.14 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.14 | $2.14 | $2.63 |
Where Iowa sits
The same service costs 1.5 times more in Alaska than in Arizona. 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· 3rd of 51
$25.70
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.