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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $141.25 | Professional | None | $120.23 | $120.23 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $218.78 Typical High $302.00 | Professional | None | $173.78 | $218.78 | $302.00 |
Medica Setting Facility Modifier None Typical Low $199.53 Median $199.53 Typical High $204.17 | Facility | None | $199.53 | $199.53 | $204.17 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $354.81 Typical High $1,096.48 | Professional | None | $199.53 | $354.81 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $302.00 | Professional | None | $245.47 | $302.00 | $302.00 |
Sanford Health Plan Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $263.03 | Professional | None | $173.78 | $194.98 | $263.03 |
United Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $354.81 | Professional | None | $199.53 | $316.23 | $354.81 |
Wellmark Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $245.47 | Professional | None | $190.55 | $245.47 | $245.47 |
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 $58.88 Median $58.88 Typical High $70.79 | Professional | 52 · Reduced service | $58.88 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $23.99 Typical High $28.84 | Professional | 53 · Discontinued | $23.99 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $17.78 Typical High $21.38 | Professional | 55 · Aftercare only | $17.78 | $17.78 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $12.02 Typical High $14.13 | Professional | 56 · Pre-op care only | $12.02 | $12.02 | $14.13 |
Where South Dakota sits
The same service costs 2.6 times more in Alaska than in Arizona. 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
$219
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.