How much rates vary
Facilitymedian $1,380 · 10th to 90th $1,380 to $1,862Professionalmedian $1,514 · 10th to 90th $1,259 to $2,692
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 $1,258.93 Median $1,479.11 Typical High $1,905.46 | Facility | None | $1,258.93 | $1,479.11 | $1,905.46 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,258.93 | $1,513.56 | $1,949.84 |
Hally Health Setting Professional Modifier None Typical Low $1,023.29 Median $1,318.26 Typical High $2,187.76 | Professional | None | $1,023.29 | $1,318.26 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $1,380.38 Median $1,659.59 Typical High $2,187.76 | Facility | None | $1,380.38 | $1,659.59 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $1,380.38 Median $1,737.80 Typical High $6,165.95 | Professional | None | $1,380.38 | $1,737.80 | $6,165.95 |
Midlands Setting Professional Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,949.84 | Professional | None | $1,513.56 | $1,513.56 | $1,949.84 |
Midlands Setting Professional Modifier None Typical Low $1,698.24 Median $1,949.84 Typical High $2,511.89 | Professional | None | $1,698.24 | $1,949.84 | $2,511.89 |
Oscar Health Setting Professional Modifier None Typical Low $1,380.38 Median $2,238.72 Typical High $2,754.23 | Professional | None | $1,380.38 | $2,238.72 | $2,754.23 |
United Setting Facility Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Facility | None | $1,258.93 | $1,258.93 | $1,258.93 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,348.96 Typical High $1,513.56 | Professional | None | $1,258.93 | $1,348.96 | $1,513.56 |
Wellmark Setting Facility Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Facility | None | $1,380.38 | $1,380.38 | $1,380.38 |
Wellmark Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,380.38 | Professional | None | $1,380.38 | $1,380.38 | $1,380.38 |
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 $630.96 Median $741.31 Typical High $954.99 | Facility | 52 · Reduced service | $630.96 | $741.31 | $954.99 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $257.04 Median $295.12 Typical High $380.19 | Facility | 53 · Discontinued | $257.04 | $295.12 | $380.19 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $190.55 Median $218.78 Typical High $288.40 | Facility | 55 · Aftercare only | $190.55 | $218.78 | $288.40 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $125.89 Median $147.91 Typical High $190.55 | Facility | 56 · Pre-op care only | $125.89 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $616.60 Median $616.60 Typical High $741.31 | Professional | 52 · Reduced service | $616.60 | $616.60 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $295.12 | Professional | 53 · Discontinued | $251.19 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $218.78 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $147.91 |
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
$1,479
AK $1,698FL $1,259
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.