How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $239.88 Median $239.88 Typical High $302.00 | Facility | None | $239.88 | $239.88 | $302.00 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $223.87 Typical High $281.84 | Professional | None | $102.33 | $223.87 | $281.84 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $457.09 Typical High $457.09 | Facility | None | $302.00 | $457.09 | $457.09 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $251.19 Typical High $281.84 | Professional | None | $100.00 | $251.19 | $281.84 |
Midlands Setting Professional Modifier None Typical Low $95.50 Median $104.71 Typical High $138.04 | Professional | None | $95.50 | $104.71 | $138.04 |
Sanford Health Plan Setting Professional Modifier None Typical Low $104.71 Median $257.04 Typical High $257.04 | Professional | None | $104.71 | $257.04 | $257.04 |
United Setting Professional Modifier None Typical Low $100.00 Median $251.19 Typical High $275.42 | Professional | None | $100.00 | $251.19 | $275.42 |
Wellmark Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Wellmark Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
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 $128.82 Median $128.82 Typical High $128.82 | Professional | 52 · Reduced service | $128.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $51.29 Typical High $51.29 | Professional | 53 · Discontinued | $51.29 | $51.29 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | 56 · Pre-op care only | $25.70 | $25.70 | $25.70 |
Where South Dakota sits
The same service costs 4.1 times more in Alaska than in Montana. 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· 33rd of 51
$251
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.