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 $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $43.65 | Professional | None | $36.31 | $36.31 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $53.70 Median $67.61 Typical High $91.20 | Professional | None | $53.70 | $67.61 | $91.20 |
Medica Setting Facility Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Facility | None | $61.66 | $61.66 | $61.66 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $107.15 Typical High $338.84 | Professional | None | $60.26 | $107.15 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $91.20 | Professional | None | $74.13 | $91.20 | $91.20 |
Sanford Health Plan Setting Professional Modifier None Typical Low $56.23 Median $58.88 Typical High $93.33 | Professional | None | $56.23 | $58.88 | $93.33 |
United Setting Professional Modifier None Typical Low $60.26 Median $95.50 Typical High $107.15 | Professional | None | $60.26 | $95.50 | $107.15 |
Wellmark Setting Professional Modifier None Typical Low $57.54 Median $74.13 Typical High $74.13 | Professional | None | $57.54 | $74.13 | $74.13 |
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 $18.20 Median $18.20 Typical High $21.88 | Professional | 52 · Reduced service | $18.20 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $8.71 | Professional | 53 · Discontinued | $7.24 | $7.24 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $5.50 Typical High $6.61 | Professional | 55 · Aftercare only | $5.50 | $5.50 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $4.37 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $4.37 |
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· 6th of 51
$66.07
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.