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 $186.21 Median $186.21 Typical High $186.21 | Facility | None | $186.21 | $186.21 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $190.55 Typical High $213.80 | Professional | None | $173.78 | $190.55 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $309.03 Typical High $380.19 | Professional | None | $281.84 | $309.03 | $380.19 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $323.59 Typical High $323.59 | Facility | None | $269.15 | $323.59 | $323.59 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $302.00 Typical High $1,174.90 | Professional | None | $173.78 | $302.00 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $288.40 | Professional | None | $281.84 | $281.84 | $288.40 |
United Setting Professional Modifier None Typical Low $173.78 Median $295.12 Typical High $354.81 | Professional | None | $173.78 | $295.12 | $354.81 |
Wellmark Setting Professional Modifier None Typical Low $208.93 Median $251.19 Typical High $251.19 | Professional | None | $208.93 | $251.19 | $251.19 |
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 $95.50 Median $95.50 Typical High $107.15 | Professional | 52 · Reduced service | $95.50 | $95.50 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $42.66 | Professional | 53 · Discontinued | $38.02 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $28.18 Typical High $31.62 | Professional | 55 · Aftercare only | $28.18 | $28.18 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $21.38 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $21.38 |
Where South Dakota sits
The same service costs 3.2 times more in Alaska than in Connecticut. 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· 9th of 51
$282
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.