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 $63.10 Median $63.10 Typical High $63.10 | Facility | None | $63.10 | $63.10 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $63.10 | Professional | None | $57.54 | $57.54 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $85.11 Typical High $128.82 | Professional | None | $61.66 | $85.11 | $128.82 |
Hally Health Setting Professional Modifier None Typical Low $83.18 Median $89.13 Typical High $131.83 | Professional | None | $83.18 | $89.13 | $131.83 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $83.18 Typical High $131.83 | Facility | None | $63.10 | $83.18 | $131.83 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $83.18 Typical High $478.63 | Professional | None | $60.26 | $83.18 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $134.90 | Professional | None | $85.11 | $85.11 | $134.90 |
Midlands Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $213.80 | Professional | None | $81.28 | $125.89 | $213.80 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $64.57 | Professional | None | $60.26 | $60.26 | $64.57 |
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 $31.62 Median $31.62 Typical High $31.62 | Facility | 52 · Reduced service | $31.62 | $31.62 | $31.62 |
Aetna Setting Facility Modifier 53 · Discontinued Typical Low $12.59 Median $12.59 Typical High $12.59 | Facility | 53 · Discontinued | $12.59 | $12.59 | $12.59 |
Aetna Setting Facility Modifier 55 · Aftercare only Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | 55 · Aftercare only | $9.33 | $9.33 | $9.33 |
Aetna Setting Facility Modifier 56 · Pre-op care only Typical Low $6.31 Median $6.31 Typical High $6.31 | Facility | 56 · Pre-op care only | $6.31 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $28.84 Median $28.84 Typical High $31.62 | Professional | 52 · Reduced service | $28.84 | $28.84 | $31.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $11.48 Typical High $12.59 | Professional | 53 · Discontinued | $11.48 | $11.48 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $9.33 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $5.75 Typical High $6.31 | Professional | 56 · Pre-op care only | $5.75 | $5.75 | $6.31 |
Where Iowa sits
The same service costs 1.6 times more in Alaska than in Hawaii. 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
$63.10
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.