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 $18.20 Median $18.20 Typical High $64.57 | Facility | None | $18.20 | $18.20 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $25.12 Typical High $81.28 | Professional | None | $18.20 | $25.12 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $45.71 Typical High $173.78 | Professional | None | $30.20 | $45.71 | $173.78 |
Medica Setting Facility Modifier None Typical Low $22.39 Median $48.98 Typical High $125.89 | Facility | None | $22.39 | $48.98 | $125.89 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $114.82 Typical High $407.38 | Professional | None | $58.88 | $114.82 | $407.38 |
Midlands Setting Professional Modifier None Typical Low $36.31 Median $45.71 Typical High $125.89 | Professional | None | $36.31 | $45.71 | $125.89 |
Midlands Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $154.88 | Professional | None | $35.48 | $35.48 | $154.88 |
Sanford Health Plan Setting Professional Modifier None Typical Low $20.42 Median $69.18 Typical High $131.83 | Professional | None | $20.42 | $69.18 | $131.83 |
United Setting Professional Modifier None Typical Low $18.20 Median $52.48 Typical High $141.25 | Professional | None | $18.20 | $52.48 | $141.25 |
Wellmark Setting Professional Modifier None Typical Low $30.20 Median $36.31 Typical High $194.98 | Professional | None | $30.20 | $36.31 | $194.98 |
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 $8.91 Median $10.72 Typical High $38.02 | Professional | 52 · Reduced service | $8.91 | $10.72 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $4.27 Typical High $15.14 | Professional | 53 · Discontinued | $3.63 | $4.27 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.69 Median $3.24 Typical High $11.22 | Professional | 55 · Aftercare only | $2.69 | $3.24 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $2.14 Typical High $7.59 | Professional | 56 · Pre-op care only | $1.82 | $2.14 | $7.59 |
Where South Dakota sits
The same service costs 4.9 times more in Hawaii than in Washington, DC. 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
$75.86
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.