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 $81.28 Median $316.23 Typical High $316.23 | Facility | None | $81.28 | $316.23 | $316.23 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $70.79 Typical High $89.13 | Professional | None | $33.88 | $70.79 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $89.13 Typical High $154.88 | Facility | None | $67.61 | $89.13 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $204.17 | Professional | None | $91.20 | $114.82 | $204.17 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $120.23 Typical High $223.87 | Facility | None | $57.54 | $120.23 | $223.87 |
Medica Setting Professional Modifier None Typical Low $81.28 Median $213.80 Typical High $616.60 | Professional | None | $81.28 | $213.80 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $186.21 | Professional | None | $109.65 | $109.65 | $186.21 |
Midlands Setting Facility Modifier None Typical Low $67.61 Median $77.62 Typical High $104.71 | Facility | None | $67.61 | $77.62 | $104.71 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $194.98 | Professional | None | $87.10 | $131.83 | $194.98 |
Sanford Health Plan Setting Professional Modifier None Typical Low $69.18 Median $95.50 Typical High $158.49 | Professional | None | $69.18 | $95.50 | $158.49 |
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 $57.54 Median $114.82 Typical High $223.87 | Professional | None | $57.54 | $114.82 | $223.87 |
Wellmark Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $245.47 | Professional | None | $81.28 | $95.50 | $245.47 |
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 $16.98 Median $35.48 Typical High $42.66 | Professional | 52 · Reduced service | $16.98 | $35.48 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $14.45 Typical High $16.98 | Professional | 53 · Discontinued | $6.76 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.01 Median $10.72 Typical High $12.88 | Professional | 55 · Aftercare only | $5.01 | $10.72 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $7.08 Typical High $8.51 | Professional | 56 · Pre-op care only | $3.39 | $7.08 | $8.51 |
Where South Dakota sits
The same service costs 3.8 times more in Alaska than in Virginia. 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· 9th of 51
$115
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.