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 $223.87 Median $223.87 Typical High $223.87 | Facility | None | $223.87 | $223.87 | $223.87 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $223.87 | Professional | None | $223.87 | $223.87 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $354.81 | Professional | None | $229.09 | $281.84 | $354.81 |
Medica Setting Facility Modifier None Typical Low $223.87 Median $380.19 Typical High $380.19 | Facility | None | $223.87 | $380.19 | $380.19 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $1,348.96 | Professional | None | $239.88 | $426.58 | $1,348.96 |
Midlands Setting Professional Modifier None Typical Low $323.59 Median $354.81 Typical High $354.81 | Professional | None | $323.59 | $354.81 | $354.81 |
Sanford Health Plan Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $338.84 | Professional | None | $229.09 | $263.03 | $338.84 |
United Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $426.58 | Professional | None | $239.88 | $380.19 | $426.58 |
Wellmark Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $331.13 | Professional | None | $251.19 | $331.13 | $331.13 |
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 $109.65 Median $112.20 Typical High $112.20 | Professional | 52 · Reduced service | $109.65 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $44.67 Typical High $44.67 | Professional | 53 · Discontinued | $44.67 | $44.67 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $33.88 Typical High $33.88 | Professional | 55 · Aftercare only | $33.11 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 56 · Pre-op care only | $22.39 | $22.39 | $22.39 |
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
$269
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.