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 $16.60 Median $16.60 Typical High $85.11 | Facility | None | $16.60 | $16.60 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $13.18 Median $33.88 Typical High $81.28 | Professional | None | $13.18 | $33.88 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $104.71 Typical High $147.91 | Facility | None | $50.12 | $104.71 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $45.71 Typical High $218.78 | Professional | None | $33.88 | $45.71 | $218.78 |
Medica Setting Facility Modifier None Typical Low $22.39 Median $117.49 Typical High $190.55 | Facility | None | $22.39 | $117.49 | $190.55 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $186.21 Typical High $588.84 | Professional | None | $72.44 | $186.21 | $588.84 |
Midlands Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $186.21 | Professional | None | $39.81 | $39.81 | $186.21 |
Midlands Setting Facility Modifier None Typical Low $50.12 Median $95.50 Typical High $104.71 | Facility | None | $50.12 | $95.50 | $104.71 |
Midlands Setting Professional Modifier None Typical Low $33.11 Median $35.48 Typical High $162.18 | Professional | None | $33.11 | $35.48 | $162.18 |
Sanford Health Plan Setting Professional Modifier None Typical Low $25.12 Median $100.00 Typical High $144.54 | Professional | None | $25.12 | $100.00 | $144.54 |
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 $19.50 Median $64.57 Typical High $239.88 | Professional | None | $19.50 | $64.57 | $239.88 |
Wellmark Setting Professional Modifier None Typical Low $28.84 Median $33.88 Typical High $190.55 | Professional | None | $28.84 | $33.88 | $190.55 |
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 $6.61 Median $16.98 Typical High $40.74 | Professional | 52 · Reduced service | $6.61 | $16.98 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.63 Median $6.76 Typical High $16.22 | Professional | 53 · Discontinued | $2.63 | $6.76 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.00 Median $5.13 Typical High $12.30 | Professional | 55 · Aftercare only | $2.00 | $5.13 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.32 Median $3.39 Typical High $8.13 | Professional | 56 · Pre-op care only | $1.32 | $3.39 | $8.13 |
Where South Dakota sits
The same service costs 5.9 times more in Iowa 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· 11th of 51
$87.10
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.