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 $45.71 Median $45.71 Typical High $100.00 | Facility | None | $45.71 | $45.71 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $63.10 Typical High $100.00 | Professional | None | $42.66 | $63.10 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $87.10 Typical High $162.18 | Professional | None | $37.15 | $87.10 | $162.18 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $117.49 Typical High $275.42 | Facility | None | $61.66 | $117.49 | $275.42 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $645.65 | Professional | None | $83.18 | $107.15 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $190.55 Typical High $194.98 | Professional | None | $87.10 | $190.55 | $194.98 |
Sanford Health Plan Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $302.00 | Professional | None | $79.43 | $154.88 | $302.00 |
United Setting Professional Modifier None Typical Low $37.15 Median $61.66 Typical High $125.89 | Professional | None | $37.15 | $61.66 | $125.89 |
Wellmark Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $177.83 | Professional | None | $66.07 | $77.62 | $177.83 |
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 $21.38 Median $31.62 Typical High $50.12 | Professional | 52 · Reduced service | $21.38 | $31.62 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $12.59 Typical High $19.95 | Professional | 53 · Discontinued | $8.51 | $12.59 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $9.55 Typical High $15.14 | Professional | 55 · Aftercare only | $6.46 | $9.55 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.31 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.27 | $6.31 | $10.00 |
Where South Dakota sits
The same service costs 2.5 times more in Alaska than in Washington, DC. 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· 6th of 51
$95.50
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.