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 $56.23 Median $69.18 Typical High $81.28 | Facility | None | $56.23 | $69.18 | $81.28 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $56.23 Typical High $69.18 | Professional | None | $56.23 | $56.23 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $64.57 Typical High $72.44 | Professional | None | $56.23 | $64.57 | $72.44 |
Hally Health Setting Professional Modifier None Typical Low $38.90 Median $60.26 Typical High $151.36 | Professional | None | $38.90 | $60.26 | $151.36 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $58.88 Typical High $74.13 | Facility | None | $50.12 | $58.88 | $74.13 |
Medica Setting Professional Modifier None Typical Low $50.12 Median $58.88 Typical High $218.78 | Professional | None | $50.12 | $58.88 | $218.78 |
Midlands Setting Professional Modifier None Typical Low $61.66 Median $64.57 Typical High $75.86 | Professional | None | $61.66 | $64.57 | $75.86 |
Midlands Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $87.10 | Professional | None | $61.66 | $61.66 | $87.10 |
Oscar Health Setting Professional Modifier None Typical Low $57.54 Median $95.50 Typical High $114.82 | Professional | None | $57.54 | $95.50 | $114.82 |
United Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
United Setting Professional Modifier None Typical Low $53.70 Median $56.23 Typical High $63.10 | Professional | None | $53.70 | $56.23 | $63.10 |
Wellmark Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Wellmark Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
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 $28.18 Median $34.67 Typical High $39.81 | Facility | 52 · Reduced service | $28.18 | $34.67 | $39.81 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $11.22 Median $13.80 Typical High $16.22 | Facility | 53 · Discontinued | $11.22 | $13.80 | $16.22 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $8.51 Median $10.23 Typical High $12.02 | Facility | 55 · Aftercare only | $8.51 | $10.23 | $12.02 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $5.62 Median $6.92 Typical High $7.94 | Facility | 56 · Pre-op care only | $5.62 | $6.92 | $7.94 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.18 Median $28.18 Typical High $34.67 | Professional | 52 · Reduced service | $28.18 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.22 Median $11.22 Typical High $13.80 | Professional | 53 · Discontinued | $11.22 | $11.22 | $13.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $8.51 Typical High $10.23 | Professional | 55 · Aftercare only | $8.51 | $8.51 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.62 Median $5.62 Typical High $6.92 | Professional | 56 · Pre-op care only | $5.62 | $5.62 | $6.92 |
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· 8th of 51
$58.88
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.