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 $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Aetna Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $676.08 | Professional | None | $660.69 | $660.69 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $1,288.25 Typical High $1,584.89 | Facility | None | $169.82 | $1,288.25 | $1,584.89 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $954.99 Typical High $1,202.26 | Professional | None | $870.96 | $954.99 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,737.80 | Facility | None | $1,230.27 | $1,230.27 | $1,737.80 |
Medica Setting Professional Modifier None Typical Low $691.83 Median $724.44 Typical High $1,659.59 | Professional | None | $691.83 | $724.44 | $1,659.59 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $870.96 | Professional | None | $870.96 | $870.96 | $870.96 |
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 $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
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 $660.69 Median $660.69 Typical High $660.69 | Facility | None | $660.69 | $660.69 | $660.69 |
Wellmark Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $660.69 | Professional | None | $660.69 | $660.69 | $660.69 |
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 $331.13 Median $331.13 Typical High $338.84 | Professional | 52 · Reduced service | $331.13 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $131.83 Typical High $134.90 | Professional | 53 · Discontinued | $131.83 | $131.83 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $97.72 Typical High $102.33 | Professional | 55 · Aftercare only | $97.72 | $97.72 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $66.07 Typical High $67.61 | Professional | 56 · Pre-op care only | $66.07 | $66.07 | $67.61 |
Where South Dakota sits
The same service costs 12.6 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· 7th of 51
$724
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.