How much rates vary
Facilitymedian $214 · 10th to 90th $162 to $468Professionalmedian $269 · 10th to 90th $145 to $347
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 $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Aetna Setting Professional Modifier None (both parts) Typical Low $128.82 Median $128.82 Typical High $144.54 | Professional | None (both parts) | $128.82 | $128.82 | $144.54 |
Aetna Setting Professional Modifier 26 · Professional part Typical Low $37.15 Median $37.15 Typical High $40.74 | Professional | 26 · Professional part | $37.15 | $37.15 | $40.74 |
Aetna Setting Professional Modifier TC · Technical part Typical Low $91.20 Median $91.20 Typical High $104.71 | Professional | TC · Technical part | $91.20 | $91.20 | $104.71 |
Cigna Setting Professional Modifier None (both parts) Typical Low $213.80 Median $239.88 Typical High $346.74 | Professional | None (both parts) | $213.80 | $239.88 | $346.74 |
Cigna Setting Professional Modifier 26 · Professional part Typical Low $58.88 Median $64.57 Typical High $97.72 | Professional | 26 · Professional part | $58.88 | $64.57 | $97.72 |
Cigna Setting Professional Modifier TC · Technical part Typical Low $158.49 Median $177.83 Typical High $251.19 | Professional | TC · Technical part | $158.49 | $177.83 | $251.19 |
Medica Setting Facility Modifier None Typical Low $181.97 Median $213.80 Typical High $467.74 | Facility | None | $181.97 | $213.80 | $467.74 |
Medica Setting Professional Modifier None (both parts) Typical Low $165.96 Median $302.00 Typical High $1,778.28 | Professional | None (both parts) | $165.96 | $302.00 | $1,778.28 |
Medica Setting Professional Modifier 26 · Professional part Typical Low $40.74 Median $79.43 Typical High $1,202.26 | Professional | 26 · Professional part | $40.74 | $79.43 | $1,202.26 |
Medica Setting Professional Modifier TC · Technical part Typical Low $131.83 Median $218.78 Typical High $1,548.82 | Professional | TC · Technical part | $131.83 | $218.78 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $288.40 | Professional | None | $269.15 | $281.84 | $288.40 |
Midlands Setting Professional Modifier None (both parts) Typical Low $186.21 Median $186.21 Typical High $288.40 | Professional | None (both parts) | $186.21 | $186.21 | $288.40 |
Sanford Health Plan Setting Professional Modifier None Typical Low $131.83 Median $199.53 Typical High $346.74 | Professional | None | $131.83 | $199.53 | $346.74 |
Sanford Health Plan Setting Professional Modifier 26 · Professional part Typical Low $42.66 Median $48.98 Typical High $87.10 | Professional | 26 · Professional part | $42.66 | $48.98 | $87.10 |
Sanford Health Plan Setting Professional Modifier TC · Technical part Typical Low $104.71 Median $151.36 Typical High $263.03 | Professional | TC · Technical part | $104.71 | $151.36 | $263.03 |
United Setting Professional Modifier None (both parts) Typical Low $138.04 Median $257.04 Typical High $346.74 | Professional | None (both parts) | $138.04 | $257.04 | $346.74 |
United Setting Professional Modifier 26 · Professional part Typical Low $36.31 Median $67.61 Typical High $79.43 | Professional | 26 · Professional part | $36.31 | $67.61 | $79.43 |
United Setting Professional Modifier TC · Technical part Typical Low $107.15 Median $190.55 Typical High $269.15 | Professional | TC · Technical part | $107.15 | $190.55 | $269.15 |
Wellmark Setting Professional Modifier None (both parts) Typical Low $269.15 Median $281.84 Typical High $331.13 | Professional | None (both parts) | $269.15 | $281.84 | $331.13 |
Wellmark Setting Professional Modifier 26 · Professional part Typical Low $74.13 Median $77.62 Typical High $91.20 | Professional | 26 · Professional part | $74.13 | $77.62 | $91.20 |
Wellmark Setting Professional Modifier TC · Technical part Typical Low $194.98 Median $204.17 Typical High $239.88 | Professional | TC · Technical part | $194.98 | $204.17 | $239.88 |
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 $64.57 Median $64.57 Typical High $72.44 | Professional | 52 · Reduced service | $64.57 | $64.57 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $28.84 | Professional | 53 · Discontinued | $25.70 | $25.70 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $21.88 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $14.45 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $14.45 |
Where South Dakota sits
The same service costs 3.2 times more in Kansas than in Utah. 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· 13th of 51
$263
KS $324UT $100
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.