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 $22.91 Median $24.55 Typical High $26.30 | Facility | None | $22.91 | $24.55 | $26.30 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $24.55 | Professional | None | $22.91 | $22.91 | $24.55 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $34.67 Typical High $43.65 | Professional | None | $28.18 | $34.67 | $43.65 |
Medica Setting Facility Modifier None Typical Low $33.11 Median $38.02 Typical High $61.66 | Facility | None | $33.11 | $38.02 | $61.66 |
Medica Setting Professional Modifier None Typical Low $54.95 Median $151.36 Typical High $158.49 | Professional | None | $54.95 | $151.36 | $158.49 |
Midlands Setting Professional Modifier None Typical Low $47.86 Median $51.29 Typical High $51.29 | Professional | None | $47.86 | $51.29 | $51.29 |
Midlands Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $51.29 | Professional | None | $47.86 | $47.86 | $51.29 |
Sanford Health Plan Setting Professional Modifier None Typical Low $26.92 Median $30.90 Typical High $51.29 | Professional | None | $26.92 | $30.90 | $51.29 |
United Setting Professional Modifier None Typical Low $21.88 Median $47.86 Typical High $61.66 | Professional | None | $21.88 | $47.86 | $61.66 |
Wellmark Setting Professional Modifier None Typical Low $22.39 Median $28.84 Typical High $36.31 | Professional | None | $22.39 | $28.84 | $36.31 |
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 $11.22 Median $11.48 Typical High $12.30 | Professional | 52 · Reduced service | $11.22 | $11.48 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $4.57 Typical High $4.90 | Professional | 53 · Discontinued | $4.57 | $4.57 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.39 Median $3.47 Typical High $3.63 | Professional | 55 · Aftercare only | $3.39 | $3.47 | $3.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $2.29 Typical High $2.45 | Professional | 56 · Pre-op care only | $2.29 | $2.29 | $2.45 |
Where South Dakota sits
The same service costs 2.8 times more in New York than in Georgia. 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· 20th of 51
$30.20
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.