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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $93.33 | Professional | None | $89.13 | $89.13 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $154.88 Typical High $169.82 | Facility | None | $125.89 | $154.88 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $112.20 Typical High $117.49 | Professional | None | $93.33 | $112.20 | $117.49 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $158.49 Typical High $223.87 | Facility | None | $158.49 | $158.49 | $223.87 |
Medica Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $213.80 | Professional | None | $79.43 | $93.33 | $213.80 |
Midlands Setting Professional Modifier None Typical Low $112.20 Median $112.20 Typical High $112.20 | Professional | None | $112.20 | $112.20 | $112.20 |
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 $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Wellmark Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
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 $44.67 Median $44.67 Typical High $46.77 | Professional | 52 · Reduced service | $44.67 | $44.67 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $18.62 | Professional | 53 · Discontinued | $17.78 | $17.78 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $13.80 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $9.33 |
Where South Dakota sits
The same service costs 2.1 times more in Wyoming 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· 47th of 51
$102
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.