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 $123.03 Median $138.04 Typical High $281.84 | Facility | None | $123.03 | $138.04 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $169.82 | Professional | None | $83.18 | $107.15 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $354.81 | Professional | None | $194.98 | $269.15 | $354.81 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $165.96 Typical High $208.93 | Facility | None | $123.03 | $165.96 | $208.93 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $302.00 Typical High $1,047.13 | Professional | None | $158.49 | $302.00 | $1,047.13 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $309.03 | Professional | None | $245.47 | $245.47 | $309.03 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $269.15 Typical High $363.08 | Professional | None | $194.98 | $269.15 | $363.08 |
Sanford Health Plan Setting Professional Modifier None Typical Low $147.91 Median $204.17 Typical High $309.03 | Professional | None | $147.91 | $204.17 | $309.03 |
United Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $316.23 | Professional | None | $117.49 | $208.93 | $316.23 |
Wellmark Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $269.15 | Professional | None | $158.49 | $177.83 | $269.15 |
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 $48.98 Median $63.10 Typical High $74.13 | Professional | 52 · Reduced service | $48.98 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $18.62 Typical High $21.88 | Professional | 55 · Aftercare only | $14.79 | $18.62 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $12.59 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.77 | $12.59 | $14.79 |
Where South Dakota sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 5th of 51
$219
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.