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 $19.05 Median $19.05 Typical High $33.11 | Facility | None | $19.05 | $19.05 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $27.54 Typical High $52.48 | Professional | None | $15.49 | $27.54 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $25.70 Median $36.31 Typical High $58.88 | Facility | None | $25.70 | $36.31 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $53.70 Typical High $85.11 | Professional | None | $38.02 | $53.70 | $85.11 |
Medica Setting Facility Modifier None Typical Low $26.30 Median $46.77 Typical High $151.36 | Facility | None | $26.30 | $46.77 | $151.36 |
Medica Setting Professional Modifier None Typical Low $36.31 Median $75.86 Typical High $338.84 | Professional | None | $36.31 | $75.86 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $74.13 | Professional | None | $44.67 | $44.67 | $74.13 |
Midlands Setting Facility Modifier None Typical Low $25.12 Median $27.54 Typical High $36.31 | Facility | None | $25.12 | $27.54 | $36.31 |
Midlands Setting Professional Modifier None Typical Low $38.90 Median $40.74 Typical High $67.61 | Professional | None | $38.90 | $40.74 | $67.61 |
Sanford Health Plan Setting Professional Modifier None Typical Low $28.84 Median $40.74 Typical High $58.88 | Professional | None | $28.84 | $40.74 | $58.88 |
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 $23.44 Median $51.29 Typical High $93.33 | Professional | None | $23.44 | $51.29 | $93.33 |
Wellmark Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $79.43 | Professional | None | $33.11 | $38.90 | $79.43 |
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 $7.76 Median $13.80 Typical High $16.22 | Professional | 52 · Reduced service | $7.76 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $5.50 Typical High $6.46 | Professional | 53 · Discontinued | $3.09 | $5.50 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $4.17 Typical High $4.90 | Professional | 55 · Aftercare only | $2.29 | $4.17 | $4.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $2.75 Typical High $3.24 | Professional | 56 · Pre-op care only | $1.55 | $2.75 | $3.24 |
Where South Dakota sits
The same service costs 3.5 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· 10th of 51
$48.98
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.