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 $28.84 Median $38.02 Typical High $42.66 | Facility | None | $28.84 | $38.02 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $28.84 Median $28.84 Typical High $38.02 | Professional | None | $28.84 | $28.84 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $33.88 Typical High $43.65 | Professional | None | $32.36 | $33.88 | $43.65 |
Hally Health Setting Professional Modifier None Typical Low $23.44 Median $28.84 Typical High $147.91 | Professional | None | $23.44 | $28.84 | $147.91 |
Medica Setting Facility Modifier None Typical Low $1.00 Median $38.02 Typical High $66.07 | Facility | None | $1.00 | $38.02 | $66.07 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $144.54 | Professional | None | $28.84 | $33.88 | $144.54 |
Midlands Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $46.77 | Professional | None | $33.88 | $33.88 | $46.77 |
Midlands Setting Professional Modifier None Typical Low $37.15 Median $46.77 Typical High $46.77 | Professional | None | $37.15 | $46.77 | $46.77 |
Oscar Health Setting Professional Modifier None Typical Low $30.90 Median $50.12 Typical High $60.26 | Professional | None | $30.90 | $50.12 | $60.26 |
United Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
United Setting Professional Modifier None Typical Low $28.84 Median $30.20 Typical High $33.88 | Professional | None | $28.84 | $30.20 | $33.88 |
Wellmark Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Wellmark Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
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 $14.13 Median $19.05 Typical High $21.38 | Facility | 52 · Reduced service | $14.13 | $19.05 | $21.38 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $5.75 Median $7.76 Typical High $8.71 | Facility | 53 · Discontinued | $5.75 | $7.76 | $8.71 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.27 Median $5.75 Typical High $6.46 | Facility | 55 · Aftercare only | $4.27 | $5.75 | $6.46 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $2.82 Median $3.80 Typical High $4.27 | Facility | 56 · Pre-op care only | $2.82 | $3.80 | $4.27 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $14.13 Median $14.13 Typical High $19.05 | Professional | 52 · Reduced service | $14.13 | $14.13 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $5.75 Typical High $7.76 | Professional | 53 · Discontinued | $5.75 | $5.75 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $4.27 Typical High $5.75 | Professional | 55 · Aftercare only | $4.27 | $4.27 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $2.82 Typical High $3.80 | Professional | 56 · Pre-op care only | $2.82 | $2.82 | $3.80 |
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· 28th of 51
$31.62
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.