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 $123.03 Median $123.03 Typical High $269.15 | Facility | None | $123.03 | $123.03 | $269.15 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $128.82 | Professional | None | $123.03 | $123.03 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $173.78 Typical High $218.78 | Facility | None | $169.82 | $173.78 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $151.36 Typical High $162.18 | Professional | None | $131.83 | $151.36 | $162.18 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $213.80 Typical High $346.74 | Facility | None | $213.80 | $213.80 | $346.74 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $288.40 | Professional | None | $109.65 | $125.89 | $288.40 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $151.36 Typical High $151.36 | Professional | None | $151.36 | $151.36 | $151.36 |
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 $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
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 $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Wellmark Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
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 $61.66 Median $61.66 Typical High $64.57 | Professional | 52 · Reduced service | $61.66 | $61.66 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $24.55 Typical High $25.70 | Professional | 53 · Discontinued | $24.55 | $24.55 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $18.62 Typical High $19.50 | Professional | 55 · Aftercare only | $18.62 | $18.62 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $12.30 Typical High $12.88 | Professional | 56 · Pre-op care only | $12.30 | $12.30 | $12.88 |
Where South Dakota sits
The same service costs 1.9 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· 12th of 51
$129
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.