How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1,096.48 Median $1,096.48 Typical High $4,365.16 | Facility | None | $1,096.48 | $1,096.48 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $977.24 Median $977.24 Typical High $1,096.48 | Professional | None | $977.24 | $977.24 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $2,511.89 Typical High $2,511.89 | Professional | None | $1,479.11 | $2,511.89 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,412.54 Typical High $1,659.59 | Facility | None | $758.58 | $1,412.54 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $2,511.89 Typical High $8,511.38 | Professional | None | $1,174.90 | $2,511.89 | $8,511.38 |
Midlands Setting Professional Modifier None Typical Low $2,454.71 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,454.71 | $2,511.89 | $2,511.89 |
Midlands Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
United Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $1,202.26 | Facility | None | $758.58 | $758.58 | $1,202.26 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $2,137.96 Typical High $2,818.38 | Professional | None | $1,096.48 | $2,137.96 | $2,818.38 |
Wellmark Setting Professional Modifier None Typical Low $3,311.31 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,311.31 | $3,890.45 | $3,890.45 |
3 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 54 · Surgery only Typical Low $741.31 Median $741.31 Typical High $831.76 | Professional | 54 · Surgery only | $741.31 | $741.31 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $147.91 Typical High $165.96 | Professional | 55 · Aftercare only | $147.91 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $97.72 Typical High $109.65 | Professional | 56 · Pre-op care only | $97.72 | $97.72 | $109.65 |
Where South Dakota sits
The same service costs 5.6 times more in Alaska than in New York. 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· 3rd of 51
$2,512
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.