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 $45.71 Median $45.71 Typical High $128.82 | Facility | None | $45.71 | $45.71 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $67.61 Typical High $144.54 | Professional | None | $42.66 | $67.61 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $117.49 Typical High $295.12 | Professional | None | $83.18 | $117.49 | $295.12 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $131.83 Typical High $218.78 | Facility | None | $61.66 | $131.83 | $218.78 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $234.42 Typical High $851.14 | Professional | None | $109.65 | $234.42 | $851.14 |
Midlands Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $234.42 | Professional | None | $89.13 | $112.20 | $234.42 |
Midlands Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $229.09 | Professional | None | $95.50 | $95.50 | $229.09 |
Sanford Health Plan Setting Professional Modifier None Typical Low $63.10 Median $144.54 Typical High $229.09 | Professional | None | $63.10 | $144.54 | $229.09 |
United Setting Professional Modifier None Typical Low $51.29 Median $109.65 Typical High $251.19 | Professional | None | $51.29 | $109.65 | $251.19 |
Wellmark Setting Professional Modifier None Typical Low $69.18 Median $83.18 Typical High $295.12 | Professional | None | $69.18 | $83.18 | $295.12 |
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 $21.38 Median $33.88 Typical High $67.61 | Professional | 52 · Reduced service | $21.38 | $33.88 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $13.49 Typical High $26.92 | Professional | 53 · Discontinued | $8.51 | $13.49 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $10.00 Typical High $20.42 | Professional | 55 · Aftercare only | $6.46 | $10.00 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $6.76 Typical High $13.49 | Professional | 56 · Pre-op care only | $4.27 | $6.76 | $13.49 |
Where South Dakota sits
The same service costs 3.5 times more in Wisconsin 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· 9th of 51
$145
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.