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 $38.02 Median $43.65 Typical High $54.95 | Facility | None | $38.02 | $43.65 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $38.02 Typical High $43.65 | Professional | None | $38.02 | $38.02 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $44.67 Typical High $47.86 | Professional | None | $38.02 | $44.67 | $47.86 |
Hally Health Setting Professional Modifier None Typical Low $36.31 Median $52.48 Typical High $102.33 | Professional | None | $36.31 | $52.48 | $102.33 |
Medica Setting Facility Modifier None Typical Low $36.31 Median $42.66 Typical High $54.95 | Facility | None | $36.31 | $42.66 | $54.95 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $42.66 Typical High $154.88 | Professional | None | $36.31 | $42.66 | $154.88 |
Midlands Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $54.95 | Professional | None | $44.67 | $44.67 | $54.95 |
Midlands Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $77.62 | Professional | None | $44.67 | $44.67 | $77.62 |
Oscar Health Setting Professional Modifier None Typical Low $39.81 Median $66.07 Typical High $79.43 | Professional | None | $39.81 | $66.07 | $79.43 |
United Setting Facility Modifier None Typical Low $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
United Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $43.65 | Professional | None | $37.15 | $38.90 | $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 $18.62 Median $21.88 Typical High $27.54 | Facility | 52 · Reduced service | $18.62 | $21.88 | $27.54 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $7.59 Median $8.71 Typical High $11.22 | Facility | 53 · Discontinued | $7.59 | $8.71 | $11.22 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $5.62 Median $6.61 Typical High $8.32 | Facility | 55 · Aftercare only | $5.62 | $6.61 | $8.32 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.37 Typical High $5.50 | Facility | 56 · Pre-op care only | $3.80 | $4.37 | $5.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.62 Median $18.62 Typical High $21.88 | Professional | 52 · Reduced service | $18.62 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $7.59 Typical High $8.71 | Professional | 53 · Discontinued | $7.59 | $7.59 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $6.61 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $3.80 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.80 | $3.80 | $4.37 |
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
$42.66
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.