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 $42.66 Median $42.66 Typical High $63.10 | Facility | None | $42.66 | $42.66 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $43.65 Typical High $60.26 | Professional | None | $42.66 | $43.65 | $60.26 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $50.12 Typical High $54.95 | Professional | None | $43.65 | $50.12 | $54.95 |
Hally Health Setting Professional Modifier None Typical Low $29.51 Median $41.69 Typical High $83.18 | Professional | None | $29.51 | $41.69 | $83.18 |
Medica Setting Facility Modifier None Typical Low $41.69 Median $48.98 Typical High $63.10 | Facility | None | $41.69 | $48.98 | $63.10 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $48.98 Typical High $53.70 | Professional | None | $41.69 | $48.98 | $53.70 |
Midlands Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $63.10 | Professional | None | $50.12 | $50.12 | $63.10 |
Midlands Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $67.61 | Professional | None | $50.12 | $54.95 | $67.61 |
Oscar Health Setting Professional Modifier None Typical Low $45.71 Median $74.13 Typical High $89.13 | Professional | None | $45.71 | $74.13 | $89.13 |
United Setting Facility Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Facility | None | $43.65 | $43.65 | $43.65 |
United Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $50.12 | Professional | None | $42.66 | $44.67 | $50.12 |
Wellmark Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Wellmark Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Professional | None | $45.71 | $45.71 | $45.71 |
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 $21.38 Median $21.38 Typical High $31.62 | Facility | 52 · Reduced service | $21.38 | $21.38 | $31.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $8.51 Median $8.51 Typical High $12.88 | Facility | 53 · Discontinued | $8.51 | $8.51 | $12.88 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $6.46 Median $6.46 Typical High $9.55 | Facility | 55 · Aftercare only | $6.46 | $6.46 | $9.55 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.27 Typical High $6.31 | Facility | 56 · Pre-op care only | $4.27 | $4.27 | $6.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $21.38 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $21.38 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.51 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $6.61 Typical High $6.61 | Professional | 55 · Aftercare only | $6.46 | $6.61 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.27 | $4.37 | $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· 8th of 51
$45.71
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.