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 $346.74 Median $346.74 Typical High $457.09 | Facility | None | $346.74 | $346.74 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $426.58 Typical High $645.65 | Professional | None | $316.23 | $426.58 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $776.25 Median $776.25 Typical High $977.24 | Facility | None | $776.25 | $776.25 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,096.48 Typical High $1,548.82 | Professional | None | $794.33 | $1,096.48 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $758.58 Typical High $1,202.26 | Facility | None | $524.81 | $758.58 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $1,202.26 Typical High $4,073.80 | Professional | None | $426.58 | $1,202.26 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $851.14 Typical High $1,023.29 | Professional | None | $794.33 | $851.14 | $1,023.29 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $741.31 | Professional | None | $575.44 | $575.44 | $741.31 |
Sanford Health Plan Setting Professional Modifier None Typical Low $524.81 Median $794.33 Typical High $1,047.13 | Professional | None | $524.81 | $794.33 | $1,047.13 |
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 $407.38 Median $912.01 Typical High $1,258.93 | Professional | None | $407.38 | $912.01 | $1,258.93 |
Wellmark Setting Professional Modifier None Typical Low $562.34 Median $676.08 Typical High $1,000.00 | Professional | None | $562.34 | $676.08 | $1,000.00 |
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 52 · Reduced service Typical Low $169.82 Median $177.83 Typical High $239.88 | Professional | 52 · Reduced service | $169.82 | $177.83 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $53.70 Typical High $72.44 | Professional | 55 · Aftercare only | $51.29 | $53.70 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $35.48 Typical High $47.86 | Professional | 56 · Pre-op care only | $33.88 | $35.48 | $47.86 |
Where South Dakota sits
The same service costs 3.1 times more in Alaska than in Indiana. 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· 9th of 51
$813
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.