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 $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $575.44 | Professional | None | $549.54 | $549.54 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $338.84 Typical High $416.87 | Facility | None | $169.82 | $338.84 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $316.23 | Professional | None | $234.42 | $251.19 | $316.23 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $331.13 Typical High $1,258.93 | Facility | None | $331.13 | $331.13 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $549.54 | Professional | None | $194.98 | $194.98 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $234.42 | Professional | None | $234.42 | $234.42 | $234.42 |
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 $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
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 $549.54 Median $549.54 Typical High $549.54 | Facility | None | $549.54 | $549.54 | $549.54 |
Wellmark Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $275.42 Median $275.42 Typical High $288.40 | Professional | 52 · Reduced service | $275.42 | $275.42 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $109.65 Typical High $114.82 | Professional | 53 · Discontinued | $109.65 | $109.65 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $83.18 Typical High $87.10 | Professional | 55 · Aftercare only | $83.18 | $83.18 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $54.95 Typical High $57.54 | Professional | 56 · Pre-op care only | $54.95 | $54.95 | $57.54 |
Where South Dakota sits
The same service costs 9.1 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· 19th of 51
$251
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.