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 $57.54 Median $57.54 Typical High $63.10 | Facility | None | $57.54 | $57.54 | $63.10 |
Aetna Setting Professional Modifier None Typical Low $57.54 Median $61.66 Typical High $72.44 | Professional | None | $57.54 | $61.66 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $128.82 | Professional | None | $91.20 | $104.71 | $128.82 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $109.65 Typical High $177.83 | Facility | None | $63.10 | $109.65 | $177.83 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $478.63 | Professional | None | $60.26 | $60.26 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Professional | None | $93.33 | $93.33 | $93.33 |
Midlands Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Sanford Health Plan Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $66.07 | Professional | None | $60.26 | $60.26 | $66.07 |
Wellmark Setting Facility Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Facility | None | $58.88 | $58.88 | $58.88 |
Wellmark Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $58.88 | Professional | None | $58.88 | $58.88 | $58.88 |
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 $28.84 Median $30.90 Typical High $36.31 | Professional | 52 · Reduced service | $28.84 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.30 Typical High $14.45 | Professional | 53 · Discontinued | $11.48 | $12.30 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.33 Typical High $10.96 | Professional | 55 · Aftercare only | $8.71 | $9.33 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.17 Typical High $7.24 | Professional | 56 · Pre-op care only | $5.75 | $6.17 | $7.24 |
Where South Dakota sits
The same service costs 1.6 times more in Alaska than in Hawaii. 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
$66.07
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.