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 $89.13 Median $89.13 Typical High $104.71 | Facility | None | $89.13 | $89.13 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $75.86 Typical High $91.20 | Professional | None | $63.10 | $75.86 | $91.20 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $169.82 Typical High $223.87 | Professional | None | $141.25 | $169.82 | $223.87 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $128.82 Typical High $199.53 | Facility | None | $104.71 | $128.82 | $199.53 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $204.17 Typical High $724.44 | Professional | None | $114.82 | $204.17 | $724.44 |
Midlands Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $199.53 | Professional | None | $162.18 | $169.82 | $199.53 |
Midlands Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $208.93 | Professional | None | $138.04 | $162.18 | $208.93 |
Sanford Health Plan Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $194.98 | Professional | None | $95.50 | $125.89 | $194.98 |
United Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $204.17 | Professional | None | $91.20 | $144.54 | $204.17 |
Wellmark Setting Professional Modifier None Typical Low $100.00 Median $104.71 Typical High $147.91 | Professional | None | $100.00 | $104.71 | $147.91 |
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 $30.90 Median $38.02 Typical High $45.71 | Professional | 52 · Reduced service | $30.90 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $11.48 Typical High $13.49 | Professional | 55 · Aftercare only | $9.33 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.59 Typical High $9.12 | Professional | 56 · Pre-op care only | $6.31 | $7.59 | $9.12 |
Where South Dakota sits
The same service costs 2.5 times more in Alaska than in Florida. 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· 8th of 51
$155
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.