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 $29.51 Median $29.51 Typical High $85.11 | Facility | None | $29.51 | $29.51 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $27.54 Median $43.65 Typical High $104.71 | Professional | None | $27.54 | $43.65 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $199.53 | Facility | None | $199.53 | $199.53 | $199.53 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $194.98 | Professional | None | $53.70 | $79.43 | $194.98 |
Medica Setting Facility Modifier None Typical Low $39.81 Median $89.13 Typical High $151.36 | Facility | None | $39.81 | $89.13 | $151.36 |
Medica Setting Professional Modifier None Typical Low $72.44 Median $162.18 Typical High $588.84 | Professional | None | $72.44 | $162.18 | $588.84 |
Midlands Setting Professional Modifier None Typical Low $57.54 Median $72.44 Typical High $154.88 | Professional | None | $57.54 | $72.44 | $154.88 |
Midlands Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $169.82 | Professional | None | $60.26 | $60.26 | $169.82 |
Sanford Health Plan Setting Professional Modifier None Typical Low $41.69 Median $97.72 Typical High $158.49 | Professional | None | $41.69 | $97.72 | $158.49 |
United Setting Professional Modifier None Typical Low $34.67 Median $72.44 Typical High $162.18 | Professional | None | $34.67 | $72.44 | $162.18 |
Wellmark Setting Professional Modifier None Typical Low $43.65 Median $53.70 Typical High $190.55 | Professional | None | $43.65 | $53.70 | $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 $13.80 Median $21.88 Typical High $44.67 | Professional | 52 · Reduced service | $13.80 | $21.88 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.50 Median $8.71 Typical High $17.78 | Professional | 53 · Discontinued | $5.50 | $8.71 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.17 Median $6.61 Typical High $13.18 | Professional | 55 · Aftercare only | $4.17 | $6.61 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.75 Median $4.37 Typical High $8.91 | Professional | 56 · Pre-op care only | $2.75 | $4.37 | $8.91 |
Where South Dakota sits
The same service costs 3.6 times more in North Carolina 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· 7th of 51
$97.72
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.