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 $33.11 Median $33.11 Typical High $100.00 | Facility | None | $33.11 | $33.11 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $31.62 Median $45.71 Typical High $104.71 | Professional | None | $31.62 | $45.71 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $27.54 Median $72.44 Typical High $169.82 | Professional | None | $27.54 | $72.44 | $169.82 |
Medica Setting Facility Modifier None Typical Low $44.67 Median $87.10 Typical High $208.93 | Facility | None | $44.67 | $87.10 | $208.93 |
Medica Setting Professional Modifier None Typical Low $79.43 Median $102.33 Typical High $645.65 | Professional | None | $79.43 | $102.33 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $63.10 Median $186.21 Typical High $194.98 | Professional | None | $63.10 | $186.21 | $194.98 |
Sanford Health Plan Setting Professional Modifier None Typical Low $58.88 Median $151.36 Typical High $309.03 | Professional | None | $58.88 | $151.36 | $309.03 |
United Setting Professional Modifier None Typical Low $28.18 Median $44.67 Typical High $123.03 | Professional | None | $28.18 | $44.67 | $123.03 |
Wellmark Setting Professional Modifier None Typical Low $48.98 Median $57.54 Typical High $181.97 | Professional | None | $48.98 | $57.54 | $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 $15.85 Median $22.91 Typical High $51.29 | Professional | 52 · Reduced service | $15.85 | $22.91 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.31 Median $9.33 Typical High $20.89 | Professional | 53 · Discontinued | $6.31 | $9.33 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $6.92 Typical High $15.49 | Professional | 55 · Aftercare only | $4.68 | $6.92 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.16 Median $4.57 Typical High $10.47 | Professional | 56 · Pre-op care only | $3.16 | $4.57 | $10.47 |
Where South Dakota sits
The same service costs 3.5 times more in Hawaii 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
$89.13
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.