How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $19.05 Median $19.05 Typical High $19.05 | Facility | None | $19.05 | $19.05 | $19.05 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $19.05 Typical High $19.05 | Professional | None | $18.62 | $19.05 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $48.98 | Facility | None | $38.90 | $38.90 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $29.51 Median $30.90 Typical High $36.31 | Professional | None | $29.51 | $30.90 | $36.31 |
Medica Setting Facility Modifier None Typical Low $21.38 Median $32.36 Typical High $33.88 | Facility | None | $21.38 | $32.36 | $33.88 |
Medica Setting Professional Modifier None Typical Low $9.77 Median $13.18 Typical High $125.89 | Professional | None | $9.77 | $13.18 | $125.89 |
Midlands Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
Midlands Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $43.65 | Professional | None | $25.70 | $25.70 | $43.65 |
Sanford Health Plan Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $33.11 | Professional | None | $25.12 | $25.12 | $33.11 |
United Setting Professional Modifier None Typical Low $9.77 Median $10.96 Typical High $21.88 | Professional | None | $9.77 | $10.96 | $21.88 |
Wellmark Setting Professional Modifier None Typical Low $22.91 Median $22.91 Typical High $22.91 | Professional | None | $22.91 | $22.91 | $22.91 |
2 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 55 · Aftercare only Typical Low $2.82 Median $2.88 Typical High $2.88 | Professional | 55 · Aftercare only | $2.82 | $2.88 | $2.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.91 Typical High $1.91 | Professional | 56 · Pre-op care only | $1.86 | $1.91 | $1.91 |
Where South Dakota sits
The same service costs 2.5 times more in Hawaii than in Colorado. 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· 13th of 51
$22.91
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.