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 $66.07 Median $66.07 Typical High $93.33 | Facility | None | $66.07 | $66.07 | $93.33 |
Aetna Setting Professional Modifier None Typical Low $56.23 Median $81.28 Typical High $117.49 | Professional | None | $56.23 | $81.28 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $100.00 Typical High $186.21 | Facility | None | $75.86 | $100.00 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $239.88 | Professional | None | $128.82 | $181.97 | $239.88 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $125.89 Typical High $223.87 | Facility | None | $87.10 | $125.89 | $223.87 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $234.42 Typical High $724.44 | Professional | None | $87.10 | $234.42 | $724.44 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $213.80 | Professional | None | $151.36 | $151.36 | $213.80 |
Midlands Setting Facility Modifier None Typical Low $75.86 Median $91.20 Typical High $117.49 | Facility | None | $75.86 | $91.20 | $117.49 |
Midlands Setting Professional Modifier None Typical Low $138.04 Median $151.36 Typical High $213.80 | Professional | None | $138.04 | $151.36 | $213.80 |
Sanford Health Plan Setting Professional Modifier None Typical Low $87.10 Median $134.90 Typical High $186.21 | Professional | None | $87.10 | $134.90 | $186.21 |
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 $79.43 Median $177.83 Typical High $263.03 | Professional | None | $79.43 | $177.83 | $263.03 |
Wellmark Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $275.42 | Professional | None | $138.04 | $162.18 | $275.42 |
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 $28.18 Median $41.69 Typical High $50.12 | Professional | 52 · Reduced service | $28.18 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $16.60 Typical High $20.42 | Professional | 53 · Discontinued | $11.48 | $16.60 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $12.59 Typical High $15.14 | Professional | 55 · Aftercare only | $8.51 | $12.59 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $8.32 Typical High $10.00 | Professional | 56 · Pre-op care only | $5.75 | $8.32 | $10.00 |
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
$158
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.