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 $104.71 Median $104.71 Typical High $239.88 | Facility | None | $104.71 | $104.71 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $239.88 | Professional | None | $104.71 | $104.71 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $162.18 | Professional | None | $107.15 | $134.90 | $162.18 |
Medica Setting Facility Modifier None Typical Low $162.18 Median $181.97 Typical High $302.00 | Facility | None | $162.18 | $181.97 | $302.00 |
Medica Setting Professional Modifier None Typical Low $107.15 Median $120.23 Typical High $162.18 | Professional | None | $107.15 | $120.23 | $162.18 |
Midlands Setting Professional Modifier None Typical Low $144.54 Median $162.18 Typical High $162.18 | Professional | None | $144.54 | $162.18 | $162.18 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Sanford Health Plan Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Professional | None | $114.82 | $114.82 | $114.82 |
United Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $144.54 | Professional | None | $120.23 | $125.89 | $144.54 |
Wellmark Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Wellmark Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
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 $52.48 Median $52.48 Typical High $120.23 | Professional | 52 · Reduced service | $52.48 | $52.48 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $47.86 | Professional | 53 · Discontinued | $20.89 | $20.89 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $36.31 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $23.99 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $23.99 |
Where South Dakota sits
The same service costs 1.9 times more in Wyoming than in Vermont. 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· 6th of 51
$132
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.