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 $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,884.03 | Professional | None | $2,754.23 | $2,754.23 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $169.82 | Facility | None | $125.89 | $158.49 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $630.96 | Professional | None | $93.33 | $117.49 | $630.96 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,995.26 | Facility | None | $758.58 | $891.25 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $524.81 Typical High $588.84 | Professional | None | $93.33 | $524.81 | $588.84 |
Midlands Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Professional | None | $630.96 | $630.96 | $630.96 |
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 $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
Sanford Health Plan Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
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 $2,754.23 Median $2,754.23 Typical High $2,754.23 | Facility | None | $2,754.23 | $2,754.23 | $2,754.23 |
Wellmark Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
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 $1,380.38 Median $1,380.38 Typical High $1,445.44 | Professional | 52 · Reduced service | $1,380.38 | $1,380.38 | $1,445.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $562.34 Median $562.34 Typical High $575.44 | Professional | 53 · Discontinued | $562.34 | $562.34 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $416.87 Median $416.87 Typical High $436.52 | Professional | 55 · Aftercare only | $416.87 | $416.87 | $436.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $275.42 Median $275.42 Typical High $288.40 | Professional | 56 · Pre-op care only | $275.42 | $275.42 | $288.40 |
Where South Dakota sits
The same service costs 37.2 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· 11th of 51
$525
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.