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 $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $11.22 Median $12.02 Typical High $13.80 | Professional | None | $11.22 | $12.02 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $8.51 Median $18.20 Typical High $25.70 | Professional | None | $8.51 | $18.20 | $25.70 |
Medica Setting Facility Modifier None Typical Low $17.38 Median $20.42 Typical High $33.11 | Facility | None | $17.38 | $20.42 | $33.11 |
Medica Setting Professional Modifier None Typical Low $10.00 Median $11.75 Typical High $281.84 | Professional | None | $10.00 | $11.75 | $281.84 |
Midlands Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | None | $21.38 | $21.38 | $22.39 |
Sanford Health Plan Setting Professional Modifier None Typical Low $14.13 Median $19.05 Typical High $37.15 | Professional | None | $14.13 | $19.05 | $37.15 |
United Setting Professional Modifier None Typical Low $9.77 Median $11.75 Typical High $16.60 | Professional | None | $9.77 | $11.75 | $16.60 |
Wellmark Setting Professional Modifier None Typical Low $22.39 Median $23.44 Typical High $27.54 | Professional | None | $22.39 | $23.44 | $27.54 |
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 $5.62 Median $6.03 Typical High $6.92 | Professional | 52 · Reduced service | $5.62 | $6.03 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.24 Median $2.45 Typical High $2.75 | Professional | 53 · Discontinued | $2.24 | $2.45 | $2.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.66 Median $1.82 Typical High $2.04 | Professional | 55 · Aftercare only | $1.66 | $1.82 | $2.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.12 Median $1.20 Typical High $1.38 | Professional | 56 · Pre-op care only | $1.12 | $1.20 | $1.38 |
Where South Dakota sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$18.20
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.