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 $457.09 Median $457.09 Typical High $457.09 | Facility | None | $457.09 | $457.09 | $457.09 |
Aetna Setting Professional Modifier None Typical Low $457.09 Median $489.78 Typical High $575.44 | Professional | None | $457.09 | $489.78 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $660.69 | Professional | None | $524.81 | $524.81 | $660.69 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $870.96 Typical High $870.96 | Facility | None | $741.31 | $870.96 | $870.96 |
Medica Setting Professional Modifier None Typical Low $575.44 Median $645.65 Typical High $645.65 | Professional | None | $575.44 | $645.65 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
United Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $645.65 | Professional | None | $575.44 | $575.44 | $645.65 |
Wellmark Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
Wellmark Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Professional | None | $302.00 | $302.00 | $302.00 |
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 $229.09 Median $245.47 Typical High $288.40 | Professional | 52 · Reduced service | $229.09 | $245.47 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $114.82 | Professional | 53 · Discontinued | $91.20 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $74.13 Typical High $87.10 | Professional | 55 · Aftercare only | $69.18 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $57.54 | Professional | 56 · Pre-op care only | $45.71 | $48.98 | $57.54 |
Where South Dakota sits
The same service costs 1.6 times more in Alaska than in Idaho. 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· 2nd of 51
$575
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.