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 $25.70 Median $25.70 Typical High $25.70 | Facility | None | $25.70 | $25.70 | $25.70 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $42.66 Typical High $42.66 | Professional | None | $23.44 | $42.66 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $37.15 Median $41.69 Typical High $52.48 | Professional | None | $37.15 | $41.69 | $52.48 |
Medica Setting Facility Modifier None Typical Low $23.44 Median $70.79 Typical High $70.79 | Facility | None | $23.44 | $70.79 | $70.79 |
Medica Setting Professional Modifier None Typical Low $21.88 Median $46.77 Typical High $151.36 | Professional | None | $21.88 | $46.77 | $151.36 |
Midlands Setting Professional Modifier None Typical Low $34.67 Median $37.15 Typical High $37.15 | Professional | None | $34.67 | $37.15 | $37.15 |
Midlands Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | None | $25.70 | $25.70 | $30.20 |
United Setting Professional Modifier None Typical Low $21.88 Median $37.15 Typical High $54.95 | Professional | None | $21.88 | $37.15 | $54.95 |
Wellmark Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | None | $1.00 | $1.00 | $1.00 |
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 $11.75 Median $20.89 Typical High $20.89 | Professional | 52 · Reduced service | $11.75 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.68 Median $8.51 Typical High $8.51 | Professional | 53 · Discontinued | $4.68 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $6.31 Typical High $6.31 | Professional | 55 · Aftercare only | $3.55 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $4.27 Typical High $4.27 | Professional | 56 · Pre-op care only | $2.34 | $4.27 | $4.27 |
Where South Dakota sits
The same service costs 2.7 times more in Alaska than in Connecticut. 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· 7th of 51
$37.15
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.