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 $45.71 Median $45.71 Typical High $57.54 | Facility | None | $45.71 | $45.71 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $57.54 | Professional | None | $48.98 | $48.98 | $57.54 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $199.53 Typical High $251.19 | Facility | None | $169.82 | $199.53 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $186.21 | Professional | None | $151.36 | $181.97 | $186.21 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $87.10 Typical High $87.10 | Facility | None | $57.54 | $87.10 | $87.10 |
Medica Setting Professional Modifier None Typical Low $57.54 Median $1,584.89 Typical High $1,737.80 | Professional | None | $57.54 | $1,584.89 | $1,737.80 |
Midlands Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $1,348.96 Median $1,348.96 Typical High $1,348.96 | Professional | None | $1,348.96 | $1,348.96 | $1,348.96 |
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 $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
Wellmark Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
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 $24.55 Median $24.55 Typical High $28.84 | Professional | 52 · Reduced service | $24.55 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $9.77 Typical High $11.48 | Professional | 53 · Discontinued | $9.77 | $9.77 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $7.24 Typical High $8.51 | Professional | 55 · Aftercare only | $7.24 | $7.24 | $8.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $4.90 Typical High $5.75 | Professional | 56 · Pre-op care only | $4.90 | $4.90 | $5.75 |
Where South Dakota sits
The same service costs 5.1 times more in North Dakota than in New Jersey. 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· 5th of 51
$182
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.