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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Aetna Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $173.78 | Professional | None | $114.82 | $141.25 | $173.78 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $190.55 Typical High $190.55 | Facility | None | $109.65 | $190.55 | $190.55 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $660.69 | Professional | None | $117.49 | $208.93 | $660.69 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $173.78 Typical High $173.78 | Professional | None | $154.88 | $173.78 | $173.78 |
Sanford Health Plan Setting Professional Modifier None Typical Low $114.82 Median $125.89 Typical High $169.82 | Professional | None | $114.82 | $125.89 | $169.82 |
United Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $208.93 | Professional | None | $117.49 | $186.21 | $208.93 |
Wellmark Setting Professional Modifier None Typical Low $120.23 Median $154.88 Typical High $154.88 | Professional | None | $120.23 | $154.88 | $154.88 |
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 $56.23 Median $56.23 Typical High $56.23 | Professional | 52 · Reduced service | $56.23 | $56.23 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $22.39 Typical High $22.39 | Professional | 53 · Discontinued | $22.39 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | 55 · Aftercare only | $16.60 | $16.60 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | 56 · Pre-op care only | $11.22 | $11.22 | $11.22 |
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
$132
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.