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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $69.18 | Professional | None | $67.61 | $67.61 | $69.18 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $107.15 Typical High $169.82 | Facility | None | $87.10 | $107.15 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $81.28 | Professional | None | $64.57 | $79.43 | $81.28 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $112.20 Typical High $208.93 | Facility | None | $112.20 | $112.20 | $208.93 |
Medica Setting Professional Modifier None Typical Low $56.23 Median $66.07 Typical High $151.36 | Professional | None | $56.23 | $66.07 | $151.36 |
Midlands Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
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 $85.11 Median $85.11 Typical High $85.11 | Professional | None | $85.11 | $85.11 | $85.11 |
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 $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Wellmark Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Professional | None | $67.61 | $67.61 | $67.61 |
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 $33.88 Median $33.88 Typical High $34.67 | Professional | 52 · Reduced service | $33.88 | $33.88 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $13.49 Typical High $14.13 | Professional | 53 · Discontinued | $13.49 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $10.00 Typical High $10.47 | Professional | 55 · Aftercare only | $10.00 | $10.00 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $6.76 Typical High $7.08 | Professional | 56 · Pre-op care only | $6.76 | $6.76 | $7.08 |
Where South Dakota sits
The same service costs 2.6 times more in Wyoming than in Washington, DC. 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
$72.44
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.