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 $85.11 Median $85.11 Typical High $120.23 | Facility | None | $85.11 | $85.11 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $107.15 Typical High $128.82 | Professional | None | $72.44 | $107.15 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $125.89 Typical High $234.42 | Facility | None | $95.50 | $125.89 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $302.00 | Professional | None | $169.82 | $234.42 | $302.00 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $151.36 Typical High $223.87 | Facility | None | $123.03 | $151.36 | $223.87 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $302.00 Typical High $933.25 | Professional | None | $114.82 | $302.00 | $933.25 |
Midlands Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $275.42 | Professional | None | $199.53 | $199.53 | $275.42 |
Midlands Setting Facility Modifier None Typical Low $95.50 Median $114.82 Typical High $151.36 | Facility | None | $95.50 | $114.82 | $151.36 |
Midlands Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $275.42 | Professional | None | $181.97 | $190.55 | $275.42 |
Sanford Health Plan Setting Professional Modifier None Typical Low $120.23 Median $173.78 Typical High $239.88 | Professional | None | $120.23 | $173.78 | $239.88 |
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 $102.33 Median $229.09 Typical High $338.84 | Professional | None | $102.33 | $229.09 | $338.84 |
Wellmark Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $354.81 | Professional | None | $177.83 | $208.93 | $354.81 |
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 $36.31 Median $53.70 Typical High $64.57 | Professional | 52 · Reduced service | $36.31 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $21.38 Typical High $25.70 | Professional | 53 · Discontinued | $14.79 | $21.38 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $16.22 Typical High $19.50 | Professional | 55 · Aftercare only | $10.96 | $16.22 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $10.72 Typical High $12.88 | Professional | 56 · Pre-op care only | $7.41 | $10.72 | $12.88 |
Where South Dakota sits
The same service costs 3.6 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· 5th of 51
$204
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.