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 $37.15 Median $37.15 Typical High $37.15 | Facility | None | $37.15 | $37.15 | $37.15 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $37.15 Typical High $46.77 | Professional | None | $35.48 | $37.15 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $74.13 Typical High $93.33 | Facility | None | $74.13 | $74.13 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $60.26 Typical High $69.18 | Professional | None | $54.95 | $60.26 | $69.18 |
Medica Setting Facility Modifier None Typical Low $42.66 Median $63.10 Typical High $66.07 | Facility | None | $42.66 | $63.10 | $66.07 |
Medica Setting Professional Modifier None Typical Low $18.20 Median $25.12 Typical High $239.88 | Professional | None | $18.20 | $25.12 | $239.88 |
Midlands Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
Midlands Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $83.18 | Professional | None | $50.12 | $50.12 | $83.18 |
Sanford Health Plan Setting Professional Modifier None Typical Low $47.86 Median $48.98 Typical High $67.61 | Professional | None | $47.86 | $48.98 | $67.61 |
United Setting Professional Modifier None Typical Low $18.20 Median $20.89 Typical High $41.69 | Professional | None | $18.20 | $20.89 | $41.69 |
Wellmark Setting Professional Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | None | $44.67 | $44.67 | $44.67 |
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 $5.25 Median $5.62 Typical High $5.62 | Professional | 55 · Aftercare only | $5.25 | $5.62 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $3.72 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.55 | $3.72 | $3.72 |
Where South Dakota sits
The same service costs 5.5 times more in Wyoming than in Utah. 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· 7th of 51
$46.77
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.