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 $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $309.03 | Professional | None | $263.03 | $263.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $177.83 Typical High $346.74 | Facility | None | $141.25 | $177.83 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $316.23 | Professional | None | $257.04 | $257.04 | $316.23 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $446.68 Typical High $446.68 | Facility | None | $295.12 | $446.68 | $446.68 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $1,047.13 | Professional | None | $208.93 | $251.19 | $1,047.13 |
Midlands Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $407.38 | Facility | None | $346.74 | $346.74 | $407.38 |
Sanford Health Plan Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
United Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $281.84 | Professional | None | $245.47 | $257.04 | $281.84 |
Wellmark Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Facility | None | $257.04 | $257.04 | $257.04 |
Wellmark Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
4 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 $131.83 Median $131.83 Typical High $154.88 | Professional | 52 · Reduced service | $131.83 | $131.83 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $52.48 Typical High $61.66 | Professional | 53 · Discontinued | $52.48 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $38.90 Typical High $45.71 | Professional | 55 · Aftercare only | $38.90 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $26.30 Typical High $30.90 | Professional | 56 · Pre-op care only | $26.30 | $26.30 | $30.90 |
Where South Dakota sits
The same service costs 1.7 times more in Alaska than in Indiana. 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· 42nd of 51
$257
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.