How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $151.36 | Professional | None | $128.82 | $128.82 | $151.36 |
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 $194.98 Median $229.09 Typical High $229.09 | Facility | None | $194.98 | $229.09 | $229.09 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $165.96 | Professional | None | $128.82 | $151.36 | $165.96 |
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 $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $141.25 | Professional | None | $120.23 | $125.89 | $141.25 |
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 $63.10 Median $63.10 Typical High $75.86 | Professional | 52 · Reduced service | $63.10 | $63.10 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $25.70 Typical High $30.20 | Professional | 53 · Discontinued | $25.70 | $25.70 | $30.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $19.05 Typical High $22.39 | Professional | 55 · Aftercare only | $19.05 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $12.88 Typical High $15.14 | Professional | 56 · Pre-op care only | $12.88 | $12.88 | $15.14 |
Where South Dakota sits
The same service costs 1.7 times more in Alaska 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· 6th of 51
$148
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.