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 $97.72 Median $134.90 Typical High $4,365.16 | Facility | None | $97.72 | $134.90 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $114.82 Typical High $165.96 | Professional | None | $83.18 | $114.82 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $128.82 Typical High $257.04 | Facility | None | $102.33 | $128.82 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $331.13 | Professional | None | $194.98 | $257.04 | $331.13 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $229.09 | Facility | None | $125.89 | $151.36 | $229.09 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $338.84 Typical High $1,023.29 | Professional | None | $125.89 | $338.84 | $1,023.29 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $302.00 | Professional | None | $229.09 | $229.09 | $302.00 |
Midlands Setting Facility Modifier None Typical Low $102.33 Median $120.23 Typical High $151.36 | Facility | None | $102.33 | $120.23 | $151.36 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $302.00 | Professional | None | $208.93 | $223.87 | $302.00 |
Sanford Health Plan Setting Professional Modifier None Typical Low $144.54 Median $190.55 Typical High $257.04 | Professional | None | $144.54 | $190.55 | $257.04 |
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 $112.20 Median $263.03 Typical High $371.54 | Professional | None | $112.20 | $263.03 | $371.54 |
Wellmark Setting Professional Modifier None Typical Low $199.53 Median $234.42 Typical High $380.19 | Professional | None | $199.53 | $234.42 | $380.19 |
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 $41.69 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $41.69 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $23.44 Typical High $28.18 | Professional | 53 · Discontinued | $16.60 | $23.44 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $17.38 Typical High $20.89 | Professional | 55 · Aftercare only | $12.30 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $11.75 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.32 | $11.75 | $14.13 |
Where South Dakota sits
The same service costs 3.7 times more in Alaska than in Florida. 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
$229
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.