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 $74.13 Median $74.13 Typical High $89.13 | Facility | None | $74.13 | $74.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $75.86 Typical High $87.10 | Professional | None | $61.66 | $75.86 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $144.54 Typical High $190.55 | Professional | None | $112.20 | $144.54 | $190.55 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $107.15 Typical High $138.04 | Facility | None | $75.86 | $107.15 | $138.04 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $169.82 Typical High $549.54 | Professional | None | $85.11 | $169.82 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $128.82 Median $144.54 Typical High $169.82 | Professional | None | $128.82 | $144.54 | $169.82 |
Midlands Setting Professional Modifier None Typical Low $97.72 Median $144.54 Typical High $190.55 | Professional | None | $97.72 | $144.54 | $190.55 |
Sanford Health Plan Setting Professional Modifier None Typical Low $87.10 Median $114.82 Typical High $158.49 | Professional | None | $87.10 | $114.82 | $158.49 |
United Setting Professional Modifier None Typical Low $66.07 Median $117.49 Typical High $169.82 | Professional | None | $66.07 | $117.49 | $169.82 |
Wellmark Setting Professional Modifier None Typical Low $102.33 Median $107.15 Typical High $154.88 | Professional | None | $102.33 | $107.15 | $154.88 |
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 $37.15 Typical High $40.74 | Professional | 52 · Reduced service | $30.90 | $37.15 | $40.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.96 Typical High $12.02 | Professional | 55 · Aftercare only | $9.33 | $10.96 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.41 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.17 | $7.41 | $8.13 |
Where South Dakota sits
The same service costs 2.9 times more in Alaska than in Florida. 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
$138
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.