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 $15.14 Median $15.14 Typical High $15.14 | Facility | None | $15.14 | $15.14 | $15.14 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $85.11 Typical High $85.11 | Professional | None | $14.13 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $83.18 Typical High $104.71 | Professional | None | $22.39 | $83.18 | $104.71 |
Medica Setting Facility Modifier None Typical Low $14.45 Median $141.25 Typical High $141.25 | Facility | None | $14.45 | $141.25 | $141.25 |
Medica Setting Professional Modifier None Typical Low $12.88 Median $26.92 Typical High $91.20 | Professional | None | $12.88 | $26.92 | $91.20 |
Midlands Setting Professional Modifier None Typical Low $20.89 Median $22.91 Typical High $22.91 | Professional | None | $20.89 | $22.91 | $22.91 |
Midlands Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $18.62 | Professional | None | $15.49 | $15.49 | $18.62 |
United Setting Professional Modifier None Typical Low $12.88 Median $22.39 Typical High $31.62 | Professional | None | $12.88 | $22.39 | $31.62 |
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 $7.08 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $7.08 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.82 Median $16.98 Typical High $16.98 | Professional | 53 · Discontinued | $2.82 | $16.98 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.14 Median $12.59 Typical High $12.59 | Professional | 55 · Aftercare only | $2.14 | $12.59 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.45 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $1.45 | $8.51 | $8.51 |
Where South Dakota sits
The same service costs 4.9 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· 8th of 51
$22.91
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.