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 $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $79.43 | Professional | None | $70.79 | $70.79 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | None | $165.96 | $165.96 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $190.55 | Professional | None | $117.49 | $147.91 | $190.55 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $120.23 Typical High $173.78 | Facility | None | $95.50 | $120.23 | $173.78 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $147.91 Typical High $489.78 | Professional | None | $83.18 | $147.91 | $489.78 |
Midlands Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $177.83 | Professional | None | $147.91 | $147.91 | $177.83 |
Midlands Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $158.49 | Professional | None | $158.49 | $158.49 | $158.49 |
Sanford Health Plan Setting Professional Modifier None Typical Low $70.79 Median $100.00 Typical High $134.90 | Professional | None | $70.79 | $100.00 | $134.90 |
United Setting Professional Modifier None Typical Low $81.28 Median $131.83 Typical High $154.88 | Professional | None | $81.28 | $131.83 | $154.88 |
Wellmark Setting Professional Modifier None Typical Low $138.04 Median $169.82 Typical High $169.82 | Professional | None | $138.04 | $169.82 | $169.82 |
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 $39.81 | Professional | 52 · Reduced service | $35.48 | $35.48 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $14.45 Typical High $15.85 | Professional | 53 · Discontinued | $14.45 | $14.45 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $10.72 Typical High $12.02 | Professional | 55 · Aftercare only | $10.72 | $10.72 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $7.08 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.08 | $7.08 | $7.94 |
Where South Dakota sits
The same service costs 3.0 times more in Alaska than in Florida. 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· 4th of 51
$148
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.