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 $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $131.83 | Professional | None | $87.10 | $107.15 | $131.83 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $144.54 Typical High $144.54 | Facility | None | $85.11 | $144.54 | $144.54 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $512.86 | Professional | None | $91.20 | $162.18 | $512.86 |
Midlands Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $131.83 | Professional | None | $120.23 | $131.83 | $131.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $91.20 Median $100.00 Typical High $125.89 | Professional | None | $91.20 | $100.00 | $125.89 |
United Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $162.18 | Professional | None | $91.20 | $144.54 | $162.18 |
Wellmark Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $123.03 | Professional | None | $95.50 | $123.03 | $123.03 |
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 $42.66 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $16.98 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $12.59 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.51 | $8.51 | $8.51 |
Where South Dakota sits
The same service costs 2.2 times more in Alaska than in Kentucky. 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
$102
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.