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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $131.83 Typical High $131.83 | Professional | None | $128.82 | $131.83 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $204.17 | Professional | None | $131.83 | $165.96 | $204.17 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $218.78 Typical High $218.78 | Facility | None | $131.83 | $218.78 | $218.78 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $251.19 Typical High $776.25 | Professional | None | $141.25 | $251.19 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $181.97 Median $204.17 Typical High $204.17 | Professional | None | $181.97 | $204.17 | $204.17 |
Sanford Health Plan Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $194.98 | Professional | None | $134.90 | $147.91 | $194.98 |
United Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $251.19 | Professional | None | $141.25 | $223.87 | $251.19 |
Wellmark Setting Professional Modifier None Typical Low $141.25 Median $181.97 Typical High $181.97 | Professional | None | $141.25 | $181.97 | $181.97 |
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 $64.57 Median $66.07 Typical High $66.07 | Professional | 52 · Reduced service | $64.57 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $26.30 Typical High $26.30 | Professional | 53 · Discontinued | $25.70 | $26.30 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $19.50 Typical High $19.50 | Professional | 55 · Aftercare only | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $13.18 Typical High $13.18 | Professional | 56 · Pre-op care only | $12.88 | $13.18 | $13.18 |
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
$158
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.