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 $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Aetna Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.90 | Professional | None | $30.20 | $30.20 | $30.90 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $41.69 Typical High $169.82 | Facility | None | $33.11 | $41.69 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $30.90 Typical High $37.15 | Professional | None | $25.12 | $30.90 | $37.15 |
Medica Setting Facility Modifier None Typical Low $48.98 Median $51.29 Typical High $51.29 | Facility | None | $48.98 | $51.29 | $51.29 |
Medica Setting Professional Modifier None Typical Low $24.55 Median $30.90 Typical High $70.79 | Professional | None | $24.55 | $30.90 | $70.79 |
Midlands Setting Professional Modifier None Typical Low $37.15 Median $37.15 Typical High $37.15 | Professional | None | $37.15 | $37.15 | $37.15 |
Midlands Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $204.17 | Facility | None | $52.48 | $52.48 | $204.17 |
Sanford Health Plan Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $141.25 | Professional | None | $120.23 | $125.89 | $141.25 |
Wellmark Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Wellmark Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
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 $14.79 Median $14.79 Typical High $15.49 | Professional | 52 · Reduced service | $14.79 | $14.79 | $15.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.03 Typical High $6.17 | Professional | 53 · Discontinued | $6.03 | $6.03 | $6.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.47 Typical High $4.68 | Professional | 55 · Aftercare only | $4.47 | $4.47 | $4.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.02 Typical High $3.09 | Professional | 56 · Pre-op care only | $3.02 | $3.02 | $3.09 |
Where South Dakota sits
The same service costs 4.2 times more in Wyoming than in Pennsylvania. 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· 46th of 51
$30.90
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.