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 $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $70.79 | Professional | None | $58.88 | $58.88 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $138.04 | Professional | None | $87.10 | $107.15 | $138.04 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $512.86 | Professional | None | $91.20 | $162.18 | $512.86 |
Midlands Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $138.04 | Professional | None | $120.23 | $138.04 | $138.04 |
Sanford Health Plan Setting Professional Modifier None Typical Low $91.20 Median $97.72 Typical High $128.82 | Professional | None | $91.20 | $97.72 | $128.82 |
United Setting Professional Modifier None Typical Low $91.20 Median $144.54 Typical High $162.18 | Professional | None | $91.20 | $144.54 | $162.18 |
Wellmark Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $123.03 | Professional | None | $95.50 | $123.03 | $123.03 |
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 $29.51 Median $29.51 Typical High $35.48 | Professional | 52 · Reduced service | $29.51 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $11.75 Typical High $14.13 | Professional | 53 · Discontinued | $11.75 | $11.75 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $8.71 Typical High $10.47 | Professional | 55 · Aftercare only | $8.71 | $8.71 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $5.89 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.89 | $5.89 | $7.08 |
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· 8th of 51
$102
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.