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 $109.65 Median $123.03 Typical High $2,238.72 | Facility | None | $109.65 | $123.03 | $2,238.72 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $95.50 Typical High $131.83 | Professional | None | $77.62 | $95.50 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $213.80 Typical High $257.04 | Professional | None | $173.78 | $213.80 | $257.04 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $147.91 Typical High $208.93 | Facility | None | $125.89 | $147.91 | $208.93 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $1,174.90 | Professional | None | $144.54 | $234.42 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $213.80 Typical High $234.42 | Professional | None | $190.55 | $213.80 | $234.42 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $186.21 Typical High $269.15 | Professional | None | $169.82 | $186.21 | $269.15 |
Sanford Health Plan Setting Professional Modifier None Typical Low $128.82 Median $181.97 Typical High $288.40 | Professional | None | $128.82 | $181.97 | $288.40 |
United Setting Professional Modifier None Typical Low $109.65 Median $194.98 Typical High $234.42 | Professional | None | $109.65 | $194.98 | $234.42 |
Wellmark Setting Professional Modifier None Typical Low $199.53 Median $204.17 Typical High $275.42 | Professional | None | $199.53 | $204.17 | $275.42 |
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 $38.90 Median $43.65 Typical High $53.70 | Professional | 52 · Reduced service | $38.90 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.18 Typical High $16.22 | Professional | 55 · Aftercare only | $11.75 | $13.18 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.71 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.76 | $8.71 | $10.72 |
Where South Dakota sits
The same service costs 2.7 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· 4th of 51
$214
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.