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 $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $102.33 Typical High $123.03 | Professional | None | $81.28 | $102.33 | $123.03 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $134.90 Typical High $134.90 | Facility | None | $77.62 | $134.90 | $134.90 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $151.36 Typical High $467.74 | Professional | None | $83.18 | $151.36 | $467.74 |
Midlands Setting Professional Modifier None Typical Low $109.65 Median $123.03 Typical High $123.03 | Professional | None | $109.65 | $123.03 | $123.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $85.11 Median $91.20 Typical High $120.23 | Professional | None | $85.11 | $91.20 | $120.23 |
United Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $151.36 | Professional | None | $83.18 | $134.90 | $151.36 |
Wellmark Setting Professional Modifier None Typical Low $87.10 Median $112.20 Typical High $112.20 | Professional | None | $87.10 | $112.20 | $112.20 |
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 $39.81 Median $39.81 Typical High $39.81 | Professional | 52 · Reduced service | $39.81 | $39.81 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $15.85 | Professional | 53 · Discontinued | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $12.02 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | 56 · Pre-op care only | $7.94 | $7.94 | $7.94 |
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
$93.33
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.