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 $87.10 Median $87.10 Typical High $120.23 | Facility | None | $87.10 | $87.10 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $120.23 | Professional | None | $72.44 | $100.00 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $257.04 | Professional | None | $131.83 | $186.21 | $257.04 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $120.23 Typical High $177.83 | Facility | None | $87.10 | $120.23 | $177.83 |
Medica Setting Professional Modifier None Typical Low $114.82 Median $223.87 Typical High $741.31 | Professional | None | $114.82 | $223.87 | $741.31 |
Midlands Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $229.09 | Professional | None | $165.96 | $165.96 | $229.09 |
Midlands Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $269.15 | Professional | None | $114.82 | $169.82 | $269.15 |
Sanford Health Plan Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $204.17 | Professional | None | $100.00 | $144.54 | $204.17 |
United Setting Professional Modifier None Typical Low $77.62 Median $144.54 Typical High $234.42 | Professional | None | $77.62 | $144.54 | $234.42 |
Wellmark Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Wellmark Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $213.80 | Professional | None | $120.23 | $125.89 | $213.80 |
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 $36.31 Median $43.65 Typical High $56.23 | Professional | 52 · Reduced service | $36.31 | $43.65 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.18 Typical High $16.60 | Professional | 55 · Aftercare only | $10.72 | $13.18 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $8.71 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.24 | $8.71 | $11.22 |
Where South Dakota sits
The same service costs 2.8 times more in Alaska than in Washington, DC. 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
$166
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.