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 $72.44 Median $72.44 Typical High $85.11 | Facility | None | $72.44 | $72.44 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $74.13 Typical High $79.43 | Professional | None | $67.61 | $74.13 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $177.83 | Professional | None | $112.20 | $138.04 | $177.83 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $114.82 Typical High $186.21 | Facility | None | $97.72 | $114.82 | $186.21 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $173.78 Typical High $512.86 | Professional | None | $74.13 | $173.78 | $512.86 |
Midlands Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $165.96 | Professional | None | $141.25 | $147.91 | $165.96 |
Midlands Setting Professional Modifier None Typical Low $89.13 Median $147.91 Typical High $186.21 | Professional | None | $89.13 | $147.91 | $186.21 |
Sanford Health Plan Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $151.36 | Professional | None | $81.28 | $102.33 | $151.36 |
United Setting Professional Modifier None Typical Low $63.10 Median $128.82 Typical High $177.83 | Professional | None | $63.10 | $128.82 | $177.83 |
Wellmark Setting Professional Modifier None Typical Low $89.13 Median $104.71 Typical High $120.23 | Professional | None | $89.13 | $104.71 | $120.23 |
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 $33.88 Median $37.15 Typical High $39.81 | Professional | 52 · Reduced service | $33.88 | $37.15 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $14.79 Typical High $15.85 | Professional | 53 · Discontinued | $13.49 | $14.79 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $11.22 Typical High $11.75 | Professional | 55 · Aftercare only | $10.23 | $11.22 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $7.41 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.76 | $7.41 | $7.94 |
Where South Dakota sits
The same service costs 8.1 times more in Alaska than in Indiana. 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
$120
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.