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 $54.95 Median $54.95 Typical High $107.15 | Facility | None | $54.95 | $54.95 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $74.13 Typical High $104.71 | Professional | None | $51.29 | $74.13 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $93.33 Typical High $169.82 | Professional | None | $44.67 | $93.33 | $169.82 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $141.25 Typical High $234.42 | Facility | None | $74.13 | $141.25 | $234.42 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $112.20 Typical High $676.08 | Professional | None | $87.10 | $112.20 | $676.08 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $199.53 Typical High $208.93 | Professional | None | $104.71 | $199.53 | $208.93 |
Sanford Health Plan Setting Professional Modifier None Typical Low $87.10 Median $162.18 Typical High $316.23 | Professional | None | $87.10 | $162.18 | $316.23 |
United Setting Professional Modifier None Typical Low $38.02 Median $72.44 Typical High $131.83 | Professional | None | $38.02 | $72.44 | $131.83 |
Wellmark Setting Professional Modifier None Typical Low $77.62 Median $91.20 Typical High $181.97 | Professional | None | $77.62 | $91.20 | $181.97 |
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 $25.70 Median $37.15 Typical High $52.48 | Professional | 52 · Reduced service | $25.70 | $37.15 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $14.79 Typical High $21.38 | Professional | 53 · Discontinued | $10.23 | $14.79 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $11.22 Typical High $15.85 | Professional | 55 · Aftercare only | $7.76 | $11.22 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $7.41 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.13 | $7.41 | $10.47 |
Where South Dakota sits
The same service costs 2.8 times more in Alaska than in Maryland. 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· 5th of 51
$105
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.