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 $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $141.25 | Professional | None | $125.89 | $125.89 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $218.78 Typical High $302.00 | Professional | None | $199.53 | $218.78 | $302.00 |
Medica Setting Facility Modifier None Typical Low $165.96 Median $213.80 Typical High $288.40 | Facility | None | $165.96 | $213.80 | $288.40 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $234.42 Typical High $776.25 | Professional | None | $112.20 | $234.42 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $257.04 Typical High $257.04 | Professional | None | $251.19 | $257.04 | $257.04 |
Midlands Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $288.40 | Professional | None | $128.82 | $128.82 | $288.40 |
Sanford Health Plan Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $229.09 | Professional | None | $128.82 | $158.49 | $229.09 |
United Setting Professional Modifier None Typical Low $112.20 Median $218.78 Typical High $275.42 | Professional | None | $112.20 | $218.78 | $275.42 |
Wellmark Setting Professional Modifier None Typical Low $151.36 Median $162.18 Typical High $190.55 | Professional | None | $151.36 | $162.18 | $190.55 |
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 $63.10 Median $63.10 Typical High $70.79 | Professional | 52 · Reduced service | $63.10 | $63.10 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $25.12 Typical High $28.18 | Professional | 53 · Discontinued | $25.12 | $25.12 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $21.38 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $12.59 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.59 | $12.59 | $14.13 |
Where South Dakota sits
The same service costs 2.8 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· 5th of 51
$191
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.