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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $95.50 Typical High $97.72 | Professional | None | $91.20 | $95.50 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $109.65 Typical High $138.04 | Professional | None | $83.18 | $109.65 | $138.04 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $158.49 Typical High $158.49 | Facility | None | $79.43 | $158.49 | $158.49 |
Medica Setting Professional Modifier None Typical Low $83.18 Median $134.90 Typical High $602.56 | Professional | None | $83.18 | $134.90 | $602.56 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $147.91 | Professional | None | $87.10 | $87.10 | $147.91 |
Midlands Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Sanford Health Plan Setting Professional Modifier None Typical Low $107.15 Median $131.83 Typical High $190.55 | Professional | None | $107.15 | $131.83 | $190.55 |
United Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $173.78 | Professional | None | $77.62 | $117.49 | $173.78 |
Wellmark Setting Professional Modifier None Typical Low $134.90 Median $138.04 Typical High $138.04 | Professional | None | $134.90 | $138.04 | $138.04 |
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 $47.86 Typical High $48.98 | Professional | 52 · Reduced service | $45.71 | $47.86 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.05 Typical High $19.50 | Professional | 53 · Discontinued | $18.20 | $19.05 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.13 Typical High $14.45 | Professional | 55 · Aftercare only | $13.80 | $14.13 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.55 Typical High $9.77 | Professional | 56 · Pre-op care only | $9.12 | $9.55 | $9.77 |
Where South Dakota sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 13th of 51
$115
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.