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 $120.23 Median $120.23 Typical High $154.88 | Facility | None | $120.23 | $120.23 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $154.88 | Professional | None | $97.72 | $123.03 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $316.23 | Professional | None | $177.83 | $245.47 | $316.23 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $165.96 Typical High $223.87 | Facility | None | $117.49 | $165.96 | $223.87 |
Medica Setting Professional Modifier None Typical Low $147.91 Median $281.84 Typical High $954.99 | Professional | None | $147.91 | $281.84 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $229.09 Typical High $288.40 | Professional | None | $223.87 | $229.09 | $288.40 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $234.42 Typical High $338.84 | Professional | None | $154.88 | $234.42 | $338.84 |
Sanford Health Plan Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $263.03 | Professional | None | $138.04 | $186.21 | $263.03 |
United Setting Professional Modifier None Typical Low $104.71 Median $194.98 Typical High $295.12 | Professional | None | $104.71 | $194.98 | $295.12 |
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 $165.96 Median $173.78 Typical High $269.15 | Professional | None | $165.96 | $173.78 | $269.15 |
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 $48.98 Median $58.88 Typical High $70.79 | Professional | 52 · Reduced service | $48.98 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $17.78 Typical High $20.89 | Professional | 55 · Aftercare only | $14.79 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $11.75 Typical High $14.13 | Professional | 56 · Pre-op care only | $9.77 | $11.75 | $14.13 |
Where South Dakota sits
The same service costs 2.7 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· 4th of 51
$229
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.