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 $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | None | $91.20 | $91.20 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $213.80 | Professional | None | $134.90 | $169.82 | $213.80 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $251.19 Typical High $794.33 | Professional | None | $141.25 | $251.19 | $794.33 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $213.80 | Professional | None | $194.98 | $213.80 | $213.80 |
Sanford Health Plan Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $204.17 | Professional | None | $134.90 | $147.91 | $204.17 |
United Setting Professional Modifier None Typical Low $141.25 Median $223.87 Typical High $251.19 | Professional | None | $141.25 | $223.87 | $251.19 |
Wellmark Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $194.98 | Professional | None | $151.36 | $194.98 | $194.98 |
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 $45.71 Median $45.71 Typical High $54.95 | Professional | 52 · Reduced service | $45.71 | $45.71 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $21.88 | Professional | 53 · Discontinued | $18.20 | $18.20 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $16.60 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $10.96 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $10.96 |
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
$155
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.