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 $407.38 Median $407.38 Typical High $478.63 | Facility | None | $407.38 | $407.38 | $478.63 |
Aetna Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $478.63 | Professional | None | $407.38 | $407.38 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $524.81 | Professional | None | $416.87 | $416.87 | $524.81 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $645.65 Typical High $645.65 | Facility | None | $446.68 | $645.65 | $645.65 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $426.58 Typical High $1,584.89 | Professional | None | $380.19 | $426.58 | $1,584.89 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $575.44 | Professional | None | $467.74 | $575.44 | $575.44 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Sanford Health Plan Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $446.68 | Professional | None | $446.68 | $446.68 | $446.68 |
United Setting Professional Modifier None Typical Low $389.05 Median $407.38 Typical High $467.74 | Professional | None | $389.05 | $407.38 | $467.74 |
Wellmark Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Facility | None | $426.58 | $426.58 | $426.58 |
Wellmark Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
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 $204.17 Median $204.17 Typical High $234.42 | Professional | 52 · Reduced service | $204.17 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $81.28 Typical High $95.50 | Professional | 53 · Discontinued | $81.28 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $61.66 Typical High $70.79 | Professional | 55 · Aftercare only | $61.66 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $40.74 Typical High $47.86 | Professional | 56 · Pre-op care only | $40.74 | $40.74 | $47.86 |
Where South Dakota sits
The same service costs 1.5 times more in Alaska than in Oklahoma. 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· 11th of 51
$427
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.