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 $77.62 | Professional | None | $63.10 | $75.86 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $186.21 Typical High $234.42 | Professional | None | $144.54 | $186.21 | $234.42 |
Medica Setting Facility Modifier None Typical Low $104.71 Median $128.82 Typical High $169.82 | Facility | None | $104.71 | $128.82 | $169.82 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $537.03 Typical High $630.96 | Professional | None | $123.03 | $537.03 | $630.96 |
Midlands Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $199.53 | Professional | None | $162.18 | $169.82 | $199.53 |
Sanford Health Plan Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $190.55 | Professional | None | $97.72 | $123.03 | $190.55 |
United Setting Professional Modifier None Typical Low $91.20 Median $165.96 Typical High $204.17 | Professional | None | $91.20 | $165.96 | $204.17 |
Wellmark Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $147.91 | Professional | None | $87.10 | $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 $38.90 | Professional | 52 · Reduced service | $30.90 | $38.02 | $38.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $11.48 Typical High $11.48 | Professional | 55 · Aftercare only | $9.33 | $11.48 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.59 Typical High $7.76 | Professional | 56 · Pre-op care only | $6.31 | $7.59 | $7.76 |
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· 7th of 51
$126
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.