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 $218.78 Median $218.78 Typical High $218.78 | Facility | None | $218.78 | $218.78 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $186.21 | Professional | None | $154.88 | $154.88 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $281.84 Typical High $363.08 | Professional | None | $229.09 | $281.84 | $363.08 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $263.03 Typical High $269.15 | Facility | None | $263.03 | $263.03 | $269.15 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $426.58 Typical High $1,348.96 | Professional | None | $239.88 | $426.58 | $1,348.96 |
Midlands Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $363.08 | Professional | None | $323.59 | $363.08 | $363.08 |
Sanford Health Plan Setting Professional Modifier None Typical Low $229.09 Median $251.19 Typical High $338.84 | Professional | None | $229.09 | $251.19 | $338.84 |
United Setting Professional Modifier None Typical Low $239.88 Median $380.19 Typical High $426.58 | Professional | None | $239.88 | $380.19 | $426.58 |
Wellmark Setting Professional Modifier None Typical Low $251.19 Median $331.13 Typical High $331.13 | Professional | None | $251.19 | $331.13 | $331.13 |
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 $77.62 Median $77.62 Typical High $93.33 | Professional | 52 · Reduced service | $77.62 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $30.90 Typical High $37.15 | Professional | 53 · Discontinued | $30.90 | $30.90 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $23.44 Typical High $27.54 | Professional | 55 · Aftercare only | $23.44 | $23.44 | $27.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $15.49 Typical High $18.62 | Professional | 56 · Pre-op care only | $15.49 | $15.49 | $18.62 |
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· 11th of 51
$263
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.