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 $50.12 Median $50.12 Typical High $64.57 | Facility | None | $50.12 | $50.12 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $54.95 Typical High $63.10 | Professional | None | $41.69 | $54.95 | $63.10 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $104.71 Typical High $131.83 | Professional | None | $75.86 | $104.71 | $131.83 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $70.79 Typical High $102.33 | Facility | None | $50.12 | $70.79 | $102.33 |
Medica Setting Professional Modifier None Typical Low $61.66 Median $123.03 Typical High $398.11 | Professional | None | $61.66 | $123.03 | $398.11 |
Midlands Setting Professional Modifier None Typical Low $93.33 Median $95.50 Typical High $123.03 | Professional | None | $93.33 | $95.50 | $123.03 |
Midlands Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $138.04 | Professional | None | $66.07 | $97.72 | $138.04 |
Sanford Health Plan Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $114.82 | Professional | None | $57.54 | $79.43 | $114.82 |
United Setting Professional Modifier None Typical Low $44.67 Median $81.28 Typical High $123.03 | Professional | None | $44.67 | $81.28 | $123.03 |
Wellmark Setting Professional Modifier None Typical Low $70.79 Median $72.44 Typical High $112.20 | Professional | None | $70.79 | $72.44 | $112.20 |
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 $20.89 Median $24.55 Typical High $29.51 | Professional | 52 · Reduced service | $20.89 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $7.41 Typical High $8.91 | Professional | 55 · Aftercare only | $6.17 | $7.41 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $4.90 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.17 | $4.90 | $5.89 |
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
$95.50
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.