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 $138.04 Median $154.88 Typical High $186.21 | Facility | None | $138.04 | $154.88 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $147.91 Typical High $177.83 | Professional | None | $109.65 | $147.91 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $162.18 Typical High $281.84 | Professional | None | $109.65 | $162.18 | $281.84 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $251.19 Typical High $302.00 | Facility | None | $158.49 | $251.19 | $302.00 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $354.81 Typical High $1,122.02 | Professional | None | $162.18 | $354.81 | $1,122.02 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $331.13 | Professional | None | $275.42 | $275.42 | $331.13 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $331.13 | Professional | None | $275.42 | $275.42 | $331.13 |
Sanford Health Plan Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $309.03 | Professional | None | $158.49 | $223.87 | $309.03 |
United Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $338.84 | Professional | None | $134.90 | $234.42 | $338.84 |
Wellmark Setting Professional Modifier None Typical Low $181.97 Median $190.55 Typical High $229.09 | Professional | None | $181.97 | $190.55 | $229.09 |
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 $74.13 Median $77.62 Typical High $89.13 | Professional | 52 · Reduced service | $74.13 | $77.62 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $22.91 Typical High $26.92 | Professional | 55 · Aftercare only | $22.39 | $22.91 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $15.49 Typical High $17.78 | Professional | 56 · Pre-op care only | $14.79 | $15.49 | $17.78 |
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· 12th of 51
$191
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.