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 $44.67 Median $208.93 Typical High $4,365.16 | Facility | None | $44.67 | $208.93 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $57.54 Typical High $239.88 | Professional | None | $36.31 | $57.54 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $151.36 Typical High $616.60 | Professional | None | $93.33 | $151.36 | $616.60 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $269.15 Typical High $467.74 | Facility | None | $57.54 | $269.15 | $467.74 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $446.68 Typical High $2,089.30 | Professional | None | $181.97 | $446.68 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $109.65 Typical High $446.68 | Professional | None | $104.71 | $109.65 | $446.68 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $93.33 Typical High $416.87 | Professional | None | $87.10 | $93.33 | $416.87 |
Sanford Health Plan Setting Professional Modifier None Typical Low $61.66 Median $234.42 Typical High $380.19 | Professional | None | $61.66 | $234.42 | $380.19 |
United Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
United Setting Professional Modifier None Typical Low $58.88 Median $125.89 Typical High $588.84 | Professional | None | $58.88 | $125.89 | $588.84 |
Wellmark Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $512.86 | Professional | None | $74.13 | $91.20 | $512.86 |
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 $18.20 Median $22.39 Typical High $104.71 | Professional | 52 · Reduced service | $18.20 | $22.39 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.91 Typical High $41.69 | Professional | 53 · Discontinued | $7.41 | $8.91 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.61 Typical High $31.62 | Professional | 55 · Aftercare only | $5.50 | $6.61 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.47 Typical High $20.89 | Professional | 56 · Pre-op care only | $3.63 | $4.47 | $20.89 |
Where South Dakota sits
The same service costs 5.2 times more in North Carolina than in Hawaii. 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
$224
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.