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 $21.88 Median $21.88 Typical High $79.43 | Facility | None | $21.88 | $21.88 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $20.89 Median $30.90 Typical High $83.18 | Professional | None | $20.89 | $30.90 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $58.88 Typical High $138.04 | Professional | None | $17.78 | $58.88 | $138.04 |
Medica Setting Facility Modifier None Typical Low $29.51 Median $72.44 Typical High $141.25 | Facility | None | $29.51 | $72.44 | $141.25 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $81.28 Typical High $524.81 | Professional | None | $63.10 | $81.28 | $524.81 |
Midlands Setting Professional Modifier None Typical Low $41.69 Median $147.91 Typical High $158.49 | Professional | None | $41.69 | $147.91 | $158.49 |
Sanford Health Plan Setting Professional Modifier None Typical Low $38.90 Median $120.23 Typical High $251.19 | Professional | None | $38.90 | $120.23 | $251.19 |
United Setting Professional Modifier None Typical Low $18.62 Median $38.02 Typical High $100.00 | Professional | None | $18.62 | $38.02 | $100.00 |
Wellmark Setting Professional Modifier None Typical Low $32.36 Median $38.02 Typical High $144.54 | Professional | None | $32.36 | $38.02 | $144.54 |
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 $10.23 Median $15.49 Typical High $41.69 | Professional | 52 · Reduced service | $10.23 | $15.49 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $6.17 Typical High $16.60 | Professional | 53 · Discontinued | $4.17 | $6.17 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $4.57 Typical High $12.59 | Professional | 55 · Aftercare only | $3.09 | $4.57 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $6.76 Typical High $8.32 | Professional | 56 · Pre-op care only | $2.04 | $6.76 | $8.32 |
Where South Dakota sits
The same service costs 4.4 times more in Hawaii 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· 5th of 51
$72.44
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.