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 $61.66 Median $61.66 Typical High $85.11 | Facility | None | $61.66 | $61.66 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $75.86 Typical High $117.49 | Professional | None | $52.48 | $75.86 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $91.20 Typical High $169.82 | Facility | None | $70.79 | $91.20 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $218.78 | Professional | None | $120.23 | $165.96 | $218.78 |
Medica Setting Facility Modifier None Typical Low $81.28 Median $125.89 Typical High $223.87 | Facility | None | $81.28 | $125.89 | $223.87 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $213.80 Typical High $660.69 | Professional | None | $81.28 | $213.80 | $660.69 |
Midlands Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $194.98 | Professional | None | $141.25 | $141.25 | $194.98 |
Midlands Setting Facility Modifier None Typical Low $70.79 Median $85.11 Typical High $109.65 | Facility | None | $70.79 | $85.11 | $109.65 |
Midlands Setting Professional Modifier None Typical Low $125.89 Median $138.04 Typical High $194.98 | Professional | None | $125.89 | $138.04 | $194.98 |
Sanford Health Plan Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $169.82 | Professional | None | $85.11 | $123.03 | $169.82 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $72.44 Median $162.18 Typical High $239.88 | Professional | None | $72.44 | $162.18 | $239.88 |
Wellmark Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $251.19 | Professional | None | $128.82 | $151.36 | $251.19 |
4 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 Professional Modifier 52 · Reduced service Typical Low $26.30 Median $38.02 Typical High $45.71 | Professional | 52 · Reduced service | $26.30 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $15.14 Typical High $18.20 | Professional | 53 · Discontinued | $10.47 | $15.14 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $11.48 Typical High $13.80 | Professional | 55 · Aftercare only | $7.94 | $11.48 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $7.59 Typical High $9.12 | Professional | 56 · Pre-op care only | $5.25 | $7.59 | $9.12 |
Where South Dakota sits
The same service costs 3.7 times more in Alaska than in Kentucky. 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.
South Dakota· 5th of 51
$148
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.