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 $89.13 Median $89.13 Typical High $120.23 | Facility | None | $89.13 | $89.13 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $120.23 | Professional | None | $74.13 | $93.33 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $186.21 Typical High $245.47 | Professional | None | $134.90 | $186.21 | $245.47 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $125.89 Typical High $173.78 | Facility | None | $93.33 | $125.89 | $173.78 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $223.87 Typical High $724.44 | Professional | None | $112.20 | $223.87 | $724.44 |
Midlands Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $223.87 | Professional | None | $173.78 | $173.78 | $223.87 |
Midlands Setting Professional Modifier None Typical Low $117.49 Median $173.78 Typical High $263.03 | Professional | None | $117.49 | $173.78 | $263.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $199.53 | Professional | None | $102.33 | $144.54 | $199.53 |
United Setting Professional Modifier None Typical Low $77.62 Median $147.91 Typical High $234.42 | Professional | None | $77.62 | $147.91 | $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 $123.03 Median $128.82 Typical High $208.93 | Professional | None | $123.03 | $128.82 | $208.93 |
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 $37.15 Median $44.67 Typical High $54.95 | Professional | 52 · Reduced service | $37.15 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $13.49 Typical High $16.60 | Professional | 55 · Aftercare only | $11.22 | $13.49 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $8.91 Typical High $10.96 | Professional | 56 · Pre-op care only | $7.41 | $8.91 | $10.96 |
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
$174
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.