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 $28.84 Median $28.84 Typical High $43.65 | Facility | None | $28.84 | $28.84 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $37.15 Typical High $44.67 | Professional | None | $23.44 | $37.15 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $33.88 Typical High $81.28 | Facility | None | $28.18 | $33.88 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $81.28 Typical High $131.83 | Professional | None | $57.54 | $81.28 | $131.83 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $63.10 Typical High $151.36 | Facility | None | $39.81 | $63.10 | $151.36 |
Medica Setting Professional Modifier None Typical Low $47.86 Median $109.65 Typical High $331.13 | Professional | None | $47.86 | $109.65 | $331.13 |
Midlands Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $102.33 | Professional | None | $67.61 | $67.61 | $102.33 |
Midlands Setting Facility Modifier None Typical Low $28.18 Median $32.36 Typical High $38.02 | Facility | None | $28.18 | $32.36 | $38.02 |
Midlands Setting Professional Modifier None Typical Low $60.26 Median $64.57 Typical High $100.00 | Professional | None | $60.26 | $64.57 | $100.00 |
Sanford Health Plan Setting Professional Modifier None Typical Low $42.66 Median $57.54 Typical High $81.28 | Professional | None | $42.66 | $57.54 | $81.28 |
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 $34.67 Median $77.62 Typical High $120.23 | Professional | None | $34.67 | $77.62 | $120.23 |
Wellmark Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $112.20 | Professional | None | $56.23 | $66.07 | $112.20 |
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 $11.75 Median $18.62 Typical High $22.39 | Professional | 52 · Reduced service | $11.75 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $7.41 Typical High $8.91 | Professional | 53 · Discontinued | $4.79 | $7.41 | $8.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $5.62 Typical High $6.76 | Professional | 55 · Aftercare only | $3.55 | $5.62 | $6.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $3.72 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.34 | $3.72 | $4.47 |
Where South Dakota sits
The same service costs 3.3 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· 7th of 51
$67.61
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.