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 $309.03 Median $346.74 Typical High $407.38 | Facility | None | $309.03 | $346.74 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $446.68 | Professional | None | $288.40 | $380.19 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $645.65 | Professional | None | $446.68 | $512.86 | $645.65 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $660.69 Typical High $758.58 | Facility | None | $323.59 | $660.69 | $758.58 |
Medica Setting Professional Modifier None Typical Low $389.05 Median $812.83 Typical High $2,754.23 | Professional | None | $389.05 | $812.83 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $478.63 Median $645.65 Typical High $645.65 | Professional | None | $478.63 | $645.65 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $457.09 Typical High $524.81 | Professional | None | $380.19 | $457.09 | $524.81 |
Sanford Health Plan Setting Professional Modifier None Typical Low $398.11 Median $588.84 Typical High $794.33 | Professional | None | $398.11 | $588.84 | $794.33 |
United Setting Professional Modifier None Typical Low $295.12 Median $524.81 Typical High $851.14 | Professional | None | $295.12 | $524.81 | $851.14 |
Wellmark Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $891.25 | Professional | None | $537.03 | $645.65 | $891.25 |
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 $194.98 Median $213.80 Typical High $223.87 | Professional | 52 · Reduced service | $194.98 | $213.80 | $223.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $85.11 Typical High $91.20 | Professional | 53 · Discontinued | $77.62 | $85.11 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $64.57 Typical High $67.61 | Professional | 55 · Aftercare only | $57.54 | $64.57 | $67.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $42.66 Typical High $44.67 | Professional | 56 · Pre-op care only | $38.90 | $42.66 | $44.67 |
Where South Dakota sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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· 9th of 51
$537
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.