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 $104.71 Median $104.71 Typical High $141.25 | Facility | None | $104.71 | $104.71 | $141.25 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $154.88 | Professional | None | $89.13 | $120.23 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $128.82 Typical High $263.03 | Facility | None | $102.33 | $128.82 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $269.15 Typical High $354.81 | Professional | None | $204.17 | $269.15 | $354.81 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $169.82 Typical High $239.88 | Facility | None | $125.89 | $169.82 | $239.88 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $346.74 Typical High $1,071.52 | Professional | None | $128.82 | $346.74 | $1,071.52 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $316.23 | Professional | None | $239.88 | $239.88 | $316.23 |
Midlands Setting Facility Modifier None Typical Low $102.33 Median $123.03 Typical High $154.88 | Facility | None | $102.33 | $123.03 | $154.88 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $234.42 Typical High $309.03 | Professional | None | $223.87 | $234.42 | $309.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $154.88 Median $199.53 Typical High $269.15 | Professional | None | $154.88 | $199.53 | $269.15 |
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 $120.23 Median $275.42 Typical High $389.05 | Professional | None | $120.23 | $275.42 | $389.05 |
Wellmark Setting Professional Modifier None Typical Low $208.93 Median $245.47 Typical High $398.11 | Professional | None | $208.93 | $245.47 | $398.11 |
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 $44.67 Median $60.26 Typical High $72.44 | Professional | 52 · Reduced service | $44.67 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $24.55 Typical High $28.84 | Professional | 53 · Discontinued | $17.78 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $18.20 Typical High $21.88 | Professional | 55 · Aftercare only | $13.18 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $12.02 Typical High $14.45 | Professional | 56 · Pre-op care only | $8.91 | $12.02 | $14.45 |
Where South Dakota sits
The same service costs 4.0 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· 6th of 51
$240
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.