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 $38.02 Median $38.02 Typical High $38.02 | Facility | None | $38.02 | $38.02 | $38.02 |
Aetna Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $46.77 | Professional | None | $39.81 | $39.81 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $194.98 Typical High $245.47 | Facility | None | $169.82 | $194.98 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $181.97 | Professional | None | $147.91 | $147.91 | $181.97 |
Medica Setting Facility Modifier None Typical Low $46.77 Median $72.44 Typical High $72.44 | Facility | None | $46.77 | $72.44 | $72.44 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $38.90 Typical High $177.83 | Professional | None | $37.15 | $38.90 | $177.83 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
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 $6.17 Median $6.17 Typical High $6.17 | Facility | None | $6.17 | $6.17 | $6.17 |
Wellmark Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.17 | Professional | None | $6.17 | $6.17 | $6.17 |
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 $19.95 Median $19.95 Typical High $23.44 | Professional | 52 · Reduced service | $19.95 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $7.94 Typical High $9.33 | Professional | 53 · Discontinued | $7.94 | $7.94 | $9.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.03 Typical High $7.08 | Professional | 55 · Aftercare only | $6.03 | $6.03 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.98 Median $3.98 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.98 | $3.98 | $4.68 |
Where South Dakota sits
The same service costs 4.8 times more in North Dakota than in Hawaii. 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· 41st of 51
$53.70
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.