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 $33.88 Median $63.10 Typical High $64.57 | Facility | None | $33.88 | $63.10 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $33.11 Typical High $51.29 | Professional | None | $21.38 | $33.11 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $79.43 Typical High $120.23 | Professional | None | $46.77 | $79.43 | $120.23 |
Medica Setting Facility Modifier None Typical Low $37.15 Median $51.29 Typical High $117.49 | Facility | None | $37.15 | $51.29 | $117.49 |
Medica Setting Professional Modifier None Typical Low $43.65 Median $85.11 Typical High $354.81 | Professional | None | $43.65 | $85.11 | $354.81 |
Midlands Setting Professional Modifier None Typical Low $47.86 Median $69.18 Typical High $85.11 | Professional | None | $47.86 | $69.18 | $85.11 |
Midlands Setting Professional Modifier None Typical Low $38.90 Median $69.18 Typical High $114.82 | Professional | None | $38.90 | $69.18 | $114.82 |
Sanford Health Plan Setting Professional Modifier None Typical Low $42.66 Median $64.57 Typical High $95.50 | Professional | None | $42.66 | $64.57 | $95.50 |
United Setting Professional Modifier None Typical Low $25.70 Median $48.98 Typical High $87.10 | Professional | None | $25.70 | $48.98 | $87.10 |
Wellmark Setting Professional Modifier None Typical Low $42.66 Median $46.77 Typical High $89.13 | Professional | None | $42.66 | $46.77 | $89.13 |
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 $12.88 Median $18.20 Typical High $25.12 | Professional | 52 · Reduced service | $12.88 | $18.20 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $5.37 Typical High $7.41 | Professional | 55 · Aftercare only | $3.89 | $5.37 | $7.41 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $3.63 Typical High $5.01 | Professional | 56 · Pre-op care only | $2.57 | $3.63 | $5.01 |
Where South Dakota sits
The same service costs 2.4 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· 14th of 51
$52.48
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.