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 $50.12 Median $50.12 Typical High $50.12 | Facility | None | $50.12 | $50.12 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $95.50 | Professional | None | $69.18 | $69.18 | $95.50 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $48.98 Typical High $85.11 | Professional | None | $39.81 | $48.98 | $85.11 |
Medica Setting Facility Modifier None Typical Low $42.66 Median $117.49 Typical High $117.49 | Facility | None | $42.66 | $117.49 | $117.49 |
Medica Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $660.69 | Professional | None | $42.66 | $42.66 | $660.69 |
Midlands Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $177.83 | Professional | None | $81.28 | $81.28 | $177.83 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $46.77 | Professional | None | $42.66 | $42.66 | $46.77 |
Wellmark Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
Wellmark Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Professional | None | $23.99 | $23.99 | $23.99 |
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 $10.23 Median $10.23 Typical High $14.45 | Professional | 55 · Aftercare only | $10.23 | $10.23 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $9.55 |
Where South Dakota sits
The same service costs 2.6 times more in Texas than in Connecticut. 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· 25th 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.