How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $50.12 Median $64.57 Typical High $128.82 | Facility | None | $50.12 | $64.57 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $45.71 Typical High $75.86 | Professional | None | $29.51 | $45.71 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $151.36 | Professional | None | $72.44 | $104.71 | $151.36 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $77.62 Typical High $93.33 | Facility | None | $50.12 | $77.62 | $93.33 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $144.54 Typical High $457.09 | Professional | None | $70.79 | $144.54 | $457.09 |
Midlands Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $144.54 | Professional | None | $95.50 | $95.50 | $144.54 |
Midlands Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $165.96 | Professional | None | $77.62 | $112.20 | $165.96 |
Sanford Health Plan Setting Professional Modifier None Typical Low $57.54 Median $89.13 Typical High $123.03 | Professional | None | $57.54 | $89.13 | $123.03 |
United Setting Professional Modifier None Typical Low $46.77 Median $83.18 Typical High $141.25 | Professional | None | $46.77 | $83.18 | $141.25 |
Wellmark Setting Professional Modifier None Typical Low $56.23 Median $61.66 Typical High $114.82 | Professional | None | $56.23 | $61.66 | $114.82 |
3 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 $17.38 Median $25.12 Typical High $31.62 | Professional | 52 · Reduced service | $17.38 | $25.12 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $7.59 Typical High $9.55 | Professional | 55 · Aftercare only | $5.25 | $7.59 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $5.01 Typical High $6.31 | Professional | 56 · Pre-op care only | $3.47 | $5.01 | $6.31 |
Where South Dakota sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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
$89.13
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.