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 $107.15 Median $107.15 Typical High $112.20 | Facility | None | $107.15 | $107.15 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $112.20 | Professional | None | $107.15 | $107.15 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $64.57 Typical High $169.82 | Facility | None | $51.29 | $64.57 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $38.90 Median $47.86 Typical High $77.62 | Professional | None | $38.90 | $47.86 | $77.62 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $112.20 | Facility | None | $109.65 | $109.65 | $112.20 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $64.57 Typical High $147.91 | Professional | None | $38.02 | $64.57 | $147.91 |
Midlands Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
Midlands Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $204.17 | Facility | None | $169.82 | $169.82 | $204.17 |
Sanford Health Plan Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
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 $107.15 Median $107.15 Typical High $107.15 | Facility | None | $107.15 | $107.15 | $107.15 |
Wellmark Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
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 $53.70 Median $53.70 Typical High $56.23 | Professional | 52 · Reduced service | $53.70 | $53.70 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $21.38 Typical High $22.39 | Professional | 53 · Discontinued | $21.38 | $21.38 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $16.22 Typical High $16.98 | Professional | 55 · Aftercare only | $16.22 | $16.22 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $10.72 Typical High $11.22 | Professional | 56 · Pre-op care only | $10.72 | $10.72 | $11.22 |
Where South Dakota sits
The same service costs 4.4 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· 48th of 51
$100
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.