How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $38.90 Median $38.90 Typical High $43.65 | Facility | None | $38.90 | $38.90 | $43.65 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $38.90 Typical High $42.66 | Professional | None | $34.67 | $38.90 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $42.66 Typical High $51.29 | Professional | None | $30.90 | $42.66 | $51.29 |
Medica Setting Facility Modifier None Typical Low $25.12 Median $60.26 Typical High $70.79 | Facility | None | $25.12 | $60.26 | $70.79 |
Medica Setting Professional Modifier None Typical Low $28.18 Median $60.26 Typical High $199.53 | Professional | None | $28.18 | $60.26 | $199.53 |
Midlands Setting Professional Modifier None Typical Low $46.77 Median $47.86 Typical High $51.29 | Professional | None | $46.77 | $47.86 | $51.29 |
Midlands Setting Professional Modifier None Typical Low $30.90 Median $44.67 Typical High $67.61 | Professional | None | $30.90 | $44.67 | $67.61 |
Sanford Health Plan Setting Professional Modifier None Typical Low $22.91 Median $39.81 Typical High $61.66 | Professional | None | $22.91 | $39.81 | $61.66 |
United Setting Professional Modifier None Typical Low $25.12 Median $44.67 Typical High $69.18 | Professional | None | $25.12 | $44.67 | $69.18 |
Wellmark Setting Professional Modifier None Typical Low $25.70 Median $31.62 Typical High $45.71 | Professional | None | $25.70 | $31.62 | $45.71 |
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 $17.78 Median $20.89 Typical High $21.38 | Professional | 52 · Reduced service | $17.78 | $20.89 | $21.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $8.32 Typical High $8.51 | Professional | 53 · Discontinued | $7.08 | $8.32 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $5.37 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.17 Typical High $4.27 | Professional | 56 · Pre-op care only | $3.55 | $4.17 | $4.27 |
Where South Dakota sits
The same service costs 3.8 times more in Alaska than in Indiana. 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· 7th of 51
$44.67
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.