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 $38.02 Typical High $60.26 | Facility | None | $38.02 | $38.02 | $60.26 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $38.02 | Professional | None | $30.90 | $30.90 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $37.15 Typical High $43.65 | Professional | None | $30.90 | $37.15 | $43.65 |
Hally Health Setting Professional Modifier None Typical Low $23.44 Median $44.67 Typical High $114.82 | Professional | None | $23.44 | $44.67 | $114.82 |
Medica Setting Facility Modifier None Typical Low $30.90 Median $38.02 Typical High $46.77 | Facility | None | $30.90 | $38.02 | $46.77 |
Medica Setting Professional Modifier None Typical Low $30.90 Median $38.02 Typical High $134.90 | Professional | None | $30.90 | $38.02 | $134.90 |
Midlands Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $46.77 | Professional | None | $37.15 | $37.15 | $46.77 |
Midlands Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $46.77 | Professional | None | $42.66 | $43.65 | $46.77 |
Oscar Health Setting Professional Modifier None Typical Low $33.11 Median $54.95 Typical High $66.07 | Professional | None | $33.11 | $54.95 | $66.07 |
United Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
United Setting Professional Modifier None Typical Low $30.90 Median $32.36 Typical High $36.31 | Professional | None | $30.90 | $32.36 | $36.31 |
Wellmark Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Wellmark Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Professional | None | $33.88 | $33.88 | $33.88 |
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 $15.49 Median $19.05 Typical High $23.44 | Facility | 52 · Reduced service | $15.49 | $19.05 | $23.44 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $6.17 Median $7.59 Typical High $9.33 | Facility | 53 · Discontinued | $6.17 | $7.59 | $9.33 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $4.57 Median $5.75 Typical High $6.92 | Facility | 55 · Aftercare only | $4.57 | $5.75 | $6.92 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.80 Typical High $4.68 | Facility | 56 · Pre-op care only | $3.09 | $3.80 | $4.68 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $15.49 Median $15.49 Typical High $19.05 | Professional | 52 · Reduced service | $15.49 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $6.17 Typical High $7.59 | Professional | 53 · Discontinued | $6.17 | $6.17 | $7.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $4.57 Typical High $5.75 | Professional | 55 · Aftercare only | $4.57 | $4.57 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.09 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.09 | $3.09 | $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· 4th of 51
$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.