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 $19.50 Median $19.50 Typical High $35.48 | Facility | None | $19.50 | $19.50 | $35.48 |
Aetna Setting Professional Modifier None Typical Low $15.49 Median $30.90 Typical High $50.12 | Professional | None | $15.49 | $30.90 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $52.48 Typical High $64.57 | Facility | None | $36.31 | $52.48 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $54.95 Typical High $93.33 | Professional | None | $38.90 | $54.95 | $93.33 |
Medica Setting Facility Modifier None Typical Low $26.30 Median $51.29 Typical High $151.36 | Facility | None | $26.30 | $51.29 | $151.36 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $79.43 Typical High $323.59 | Professional | None | $38.02 | $79.43 | $323.59 |
Midlands Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $79.43 | Professional | None | $45.71 | $45.71 | $79.43 |
Midlands Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Midlands Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $70.79 | Professional | None | $39.81 | $41.69 | $70.79 |
Sanford Health Plan Setting Professional Modifier None Typical Low $30.20 Median $44.67 Typical High $63.10 | Professional | None | $30.20 | $44.67 | $63.10 |
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 $23.99 Median $52.48 Typical High $100.00 | Professional | None | $23.99 | $52.48 | $100.00 |
Wellmark Setting Professional Modifier None Typical Low $33.11 Median $38.90 Typical High $89.13 | Professional | None | $33.11 | $38.90 | $89.13 |
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 $15.14 Typical High $17.78 | Professional | 52 · Reduced service | $7.76 | $15.14 | $17.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.09 Median $6.03 Typical High $7.08 | Professional | 53 · Discontinued | $3.09 | $6.03 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.29 Median $4.47 Typical High $5.37 | Professional | 55 · Aftercare only | $2.29 | $4.47 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.55 Median $3.02 Typical High $3.55 | Professional | 56 · Pre-op care only | $1.55 | $3.02 | $3.55 |
Where South Dakota sits
The same service costs 3.8 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· 8th of 51
$52.48
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.