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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $95.50 | Professional | None | $91.20 | $91.20 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $117.49 Typical High $169.82 | Facility | None | $93.33 | $117.49 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $81.28 Typical High $87.10 | Professional | None | $69.18 | $81.28 | $87.10 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $158.49 | Facility | None | $114.82 | $114.82 | $158.49 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $67.61 Typical High $154.88 | Professional | None | $58.88 | $67.61 | $154.88 |
Midlands Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
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 $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
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 $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
Wellmark Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Professional | None | $91.20 | $91.20 | $91.20 |
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 $45.71 Median $45.71 Typical High $47.86 | Professional | 52 · Reduced service | $45.71 | $45.71 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $18.20 Typical High $19.05 | Professional | 53 · Discontinued | $18.20 | $18.20 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $13.80 Typical High $14.13 | Professional | 55 · Aftercare only | $13.80 | $13.80 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.12 Typical High $9.55 | Professional | 56 · Pre-op care only | $9.12 | $9.12 | $9.55 |
Where South Dakota sits
The same service costs 2.1 times more in Alaska than in Montana. 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· 45th of 51
$91.20
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.