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 $56.23 Median $56.23 Typical High $69.18 | Facility | None | $56.23 | $56.23 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $51.29 Typical High $52.48 | Professional | None | $39.81 | $51.29 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $120.23 Typical High $154.88 | Professional | None | $93.33 | $120.23 | $154.88 |
Medica Setting Facility Modifier None Typical Low $66.07 Median $77.62 Typical High $109.65 | Facility | None | $66.07 | $77.62 | $109.65 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $346.74 Typical High $426.58 | Professional | None | $83.18 | $346.74 | $426.58 |
Midlands Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $131.83 | Professional | None | $109.65 | $109.65 | $131.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $63.10 Median $83.18 Typical High $123.03 | Professional | None | $63.10 | $83.18 | $123.03 |
United Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $134.90 | Professional | None | $60.26 | $107.15 | $134.90 |
Wellmark Setting Professional Modifier None Typical Low $54.95 Median $66.07 Typical High $100.00 | Professional | None | $54.95 | $66.07 | $100.00 |
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 $19.95 Median $25.70 Typical High $25.70 | Professional | 52 · Reduced service | $19.95 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $7.76 Typical High $7.76 | Professional | 55 · Aftercare only | $6.03 | $7.76 | $7.76 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $5.13 Typical High $5.13 | Professional | 56 · Pre-op care only | $3.98 | $5.13 | $5.13 |
Where South Dakota sits
The same service costs 2.6 times more in Alaska than in Kentucky. 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· 6th of 51
$85.11
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.