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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Professional | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $87.10 | Professional | None | $54.95 | $69.18 | $87.10 |
Medica Setting Facility Modifier None Typical Low $56.23 Median $91.20 Typical High $91.20 | Facility | None | $56.23 | $91.20 | $91.20 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $331.13 | Professional | None | $60.26 | $107.15 | $331.13 |
Midlands Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $87.10 | Professional | None | $74.13 | $87.10 | $87.10 |
Sanford Health Plan Setting Professional Modifier None Typical Low $56.23 Median $63.10 Typical High $91.20 | Professional | None | $56.23 | $63.10 | $91.20 |
United Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $107.15 | Professional | None | $60.26 | $95.50 | $107.15 |
Wellmark Setting Professional Modifier None Typical Low $57.54 Median $74.13 Typical High $74.13 | Professional | None | $57.54 | $74.13 | $74.13 |
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 $26.92 Median $26.92 Typical High $26.92 | Professional | 52 · Reduced service | $26.92 | $26.92 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $10.72 Typical High $10.72 | Professional | 53 · Discontinued | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 55 · Aftercare only | $7.94 | $7.94 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | 56 · Pre-op care only | $5.37 | $5.37 | $5.37 |
Where South Dakota sits
The same service costs 2.2 times more in Alaska than in Arizona. 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· 8th of 51
$67.61
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.