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 $123.03 Median $123.03 Typical High $208.93 | Facility | None | $123.03 | $123.03 | $208.93 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $851.14 Typical High $851.14 | Professional | None | $181.97 | $851.14 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $288.40 Typical High $363.08 | Facility | None | $288.40 | $288.40 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $199.53 Typical High $331.13 | Professional | None | $125.89 | $199.53 | $331.13 |
Medica Setting Facility Modifier None Typical Low $1,202.26 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,202.26 | $1,445.44 | $1,445.44 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $316.23 Typical High $5,011.87 | Professional | None | $60.26 | $316.23 | $5,011.87 |
Midlands Setting Professional Modifier None Typical Low $199.53 Median $269.15 Typical High $331.13 | Professional | None | $199.53 | $269.15 | $331.13 |
Sanford Health Plan Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $323.59 | Professional | None | $263.03 | $263.03 | $323.59 |
United Setting Professional Modifier None Typical Low $70.79 Median $257.04 Typical High $436.52 | Professional | None | $70.79 | $257.04 | $436.52 |
Wellmark Setting Professional Modifier None Typical Low $398.11 Median $489.78 Typical High $489.78 | Professional | None | $398.11 | $489.78 | $489.78 |
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 $91.20 Median $426.58 Typical High $426.58 | Professional | 52 · Reduced service | $91.20 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $169.82 Typical High $169.82 | Professional | 53 · Discontinued | $36.31 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $27.54 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $85.11 Typical High $85.11 | Professional | 56 · Pre-op care only | $18.20 | $85.11 | $85.11 |
Where South Dakota sits
The same service costs 7.6 times more in Colorado than in Rhode Island. 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· 18th of 51
$257
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.