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 $1,202.26 Median $1,202.26 Typical High $1,202.26 | Facility | None | $1,202.26 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,258.93 | $1,258.93 | $1,479.11 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $489.78 | Facility | None | $398.11 | $398.11 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $446.68 | Professional | None | $295.12 | $371.54 | $446.68 |
Medica Setting Facility Modifier None Typical Low $1,479.11 Median $2,290.87 Typical High $2,290.87 | Facility | None | $1,479.11 | $2,290.87 | $2,290.87 |
Medica Setting Professional Modifier None Typical Low $1,174.90 Median $1,258.93 Typical High $5,623.41 | Professional | None | $1,174.90 | $1,258.93 | $5,623.41 |
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 $1,174.90 Median $1,258.93 Typical High $1,380.38 | Professional | None | $1,174.90 | $1,258.93 | $1,380.38 |
Wellmark Setting Facility Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,348.96 | Facility | None | $1,348.96 | $1,348.96 | $1,348.96 |
Wellmark 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 |
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 $630.96 Median $630.96 Typical High $741.31 | Professional | 52 · Reduced service | $630.96 | $630.96 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $302.00 | Professional | 53 · Discontinued | $251.19 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $190.55 Median $190.55 Typical High $223.87 | Professional | 55 · Aftercare only | $190.55 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $147.91 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $147.91 |
Where South Dakota sits
The same service costs 6.9 times more in Alaska than in Kentucky. 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· 8th of 51
$1,259
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.