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 $42.66 Median $42.66 Typical High $61.66 | Facility | None | $42.66 | $42.66 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $56.23 Typical High $66.07 | Professional | None | $37.15 | $56.23 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $52.48 Typical High $120.23 | Facility | None | $45.71 | $52.48 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $120.23 Typical High $154.88 | Professional | None | $87.10 | $120.23 | $154.88 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $93.33 Typical High $165.96 | Facility | None | $57.54 | $93.33 | $165.96 |
Medica Setting Professional Modifier None Typical Low $61.66 Median $158.49 Typical High $489.78 | Professional | None | $61.66 | $158.49 | $489.78 |
Midlands Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $144.54 | Professional | None | $102.33 | $102.33 | $144.54 |
Midlands Setting Facility Modifier None Typical Low $45.71 Median $51.29 Typical High $63.10 | Facility | None | $45.71 | $51.29 | $63.10 |
Midlands Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $141.25 | Professional | None | $91.20 | $97.72 | $141.25 |
Sanford Health Plan Setting Professional Modifier None Typical Low $58.88 Median $87.10 Typical High $123.03 | Professional | None | $58.88 | $87.10 | $123.03 |
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 $52.48 Median $114.82 Typical High $169.82 | Professional | None | $52.48 | $114.82 | $169.82 |
Wellmark Setting Professional Modifier None Typical Low $83.18 Median $100.00 Typical High $169.82 | Professional | None | $83.18 | $100.00 | $169.82 |
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 $18.62 Median $27.54 Typical High $33.11 | Professional | 52 · Reduced service | $18.62 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $11.22 Typical High $13.18 | Professional | 53 · Discontinued | $7.41 | $11.22 | $13.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $8.32 Typical High $9.77 | Professional | 55 · Aftercare only | $5.50 | $8.32 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $5.62 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.72 | $5.62 | $6.61 |
Where South Dakota sits
The same service costs 3.5 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
$102
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.