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 $102.33 Median $102.33 Typical High $269.15 | Facility | None | $102.33 | $102.33 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $107.15 | Professional | None | $102.33 | $102.33 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $169.82 Typical High $173.78 | Facility | None | $138.04 | $169.82 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $128.82 | Professional | None | $104.71 | $120.23 | $128.82 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $269.15 | Facility | None | $169.82 | $169.82 | $269.15 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $229.09 | Professional | None | $87.10 | $100.00 | $229.09 |
Midlands Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Midlands Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $204.17 | Facility | None | $169.82 | $169.82 | $204.17 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Sanford Health Plan Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Wellmark Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Professional | None | $102.33 | $102.33 | $102.33 |
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 $51.29 Median $51.29 Typical High $53.70 | Professional | 52 · Reduced service | $51.29 | $51.29 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $20.42 Typical High $21.38 | Professional | 53 · Discontinued | $20.42 | $20.42 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $15.14 Typical High $15.85 | Professional | 55 · Aftercare only | $15.14 | $15.14 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $10.23 Typical High $10.72 | Professional | 56 · Pre-op care only | $10.23 | $10.23 | $10.72 |
Where South Dakota sits
The same service costs 2.4 times more in Wyoming than in North Carolina. 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· 45th of 51
$110
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.