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 $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $363.08 | Professional | None | $346.74 | $346.74 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $489.78 Typical High $616.60 | Facility | None | $169.82 | $489.78 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $371.54 Typical High $457.09 | Professional | None | $323.59 | $371.54 | $457.09 |
Medica Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $812.83 | Facility | None | $602.56 | $602.56 | $812.83 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $354.81 Typical High $812.83 | Professional | None | $309.03 | $354.81 | $812.83 |
Midlands Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
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 $977.24 Median $977.24 Typical High $977.24 | Professional | None | $977.24 | $977.24 | $977.24 |
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 $346.74 Median $346.74 Typical High $346.74 | Facility | None | $346.74 | $346.74 | $346.74 |
Wellmark Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
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 $173.78 Median $173.78 Typical High $181.97 | Professional | 52 · Reduced service | $173.78 | $173.78 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $69.18 Typical High $72.44 | Professional | 53 · Discontinued | $69.18 | $69.18 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $54.95 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $34.67 Typical High $36.31 | Professional | 56 · Pre-op care only | $34.67 | $34.67 | $36.31 |
Where South Dakota sits
The same service costs 5.9 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· 9th of 51
$355
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.