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 $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $154.88 | Professional | None | $83.18 | $125.89 | $154.88 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $120.23 Typical High $120.23 | Facility | None | $64.57 | $120.23 | $120.23 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $138.04 Typical High $407.38 | Professional | None | $60.26 | $138.04 | $407.38 |
Midlands Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $125.89 | Professional | None | $97.72 | $97.72 | $125.89 |
Sanford Health Plan Setting Professional Modifier None Typical Low $75.86 Median $83.18 Typical High $117.49 | Professional | None | $75.86 | $83.18 | $117.49 |
United Setting Professional Modifier None Typical Low $60.26 Median $117.49 Typical High $138.04 | Professional | None | $60.26 | $117.49 | $138.04 |
Wellmark Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $177.83 | Professional | None | $144.54 | $177.83 | $177.83 |
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 $35.48 Median $35.48 Typical High $35.48 | Professional | 52 · Reduced service | $35.48 | $35.48 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $14.45 | Professional | 53 · Discontinued | $14.45 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $7.24 Typical High $7.24 | Professional | 56 · Pre-op care only | $7.24 | $7.24 | $7.24 |
Where South Dakota sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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· 3rd of 51
$126
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.