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 $64.57 Median $74.13 Typical High $74.13 | Facility | None | $64.57 | $74.13 | $74.13 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $58.88 Typical High $95.50 | Professional | None | $33.88 | $58.88 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $102.33 Typical High $128.82 | Facility | None | $57.54 | $102.33 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $165.96 | Professional | None | $77.62 | $117.49 | $165.96 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $97.72 Typical High $223.87 | Facility | None | $57.54 | $97.72 | $223.87 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $162.18 Typical High $501.19 | Professional | None | $63.10 | $162.18 | $501.19 |
Midlands Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $144.54 | Professional | None | $91.20 | $91.20 | $144.54 |
Midlands Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $144.54 | Professional | None | $87.10 | $131.83 | $144.54 |
Sanford Health Plan Setting Professional Modifier None Typical Low $56.23 Median $79.43 Typical High $128.82 | Professional | None | $56.23 | $79.43 | $128.82 |
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 $46.77 Median $104.71 Typical High $177.83 | Professional | None | $46.77 | $104.71 | $177.83 |
Wellmark Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $204.17 | Professional | None | $89.13 | $104.71 | $204.17 |
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 $29.51 Typical High $35.48 | Professional | 52 · Reduced service | $16.98 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $11.75 Typical High $14.13 | Professional | 53 · Discontinued | $6.76 | $11.75 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $8.71 Typical High $10.72 | Professional | 55 · Aftercare only | $5.13 | $8.71 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $5.89 Typical High $7.08 | Professional | 56 · Pre-op care only | $3.39 | $5.89 | $7.08 |
Where South Dakota sits
The same service costs 4.0 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· 6th of 51
$102
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.