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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,513.56 | Professional | None | $1,445.44 | $1,445.44 | $1,513.56 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $2,398.83 Typical High $3,019.95 | Facility | None | $169.82 | $2,398.83 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,089.30 Typical High $2,238.72 | Professional | None | $1,819.70 | $2,089.30 | $2,238.72 |
Medica Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,019.95 | Facility | None | $2,884.03 | $2,884.03 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $3,981.07 | Professional | None | $1,479.11 | $1,737.80 | $3,981.07 |
Midlands Setting Professional Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,089.30 | Professional | None | $2,089.30 | $2,089.30 | $2,089.30 |
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 $2,570.40 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,570.40 | $2,570.40 | $2,570.40 |
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 $1,445.44 Median $1,445.44 Typical High $1,445.44 | Facility | None | $1,445.44 | $1,445.44 | $1,445.44 |
Wellmark Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,445.44 | Professional | None | $1,445.44 | $1,445.44 | $1,445.44 |
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 $724.44 Median $724.44 Typical High $758.58 | Professional | 52 · Reduced service | $724.44 | $724.44 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $288.40 Median $288.40 Typical High $302.00 | Professional | 53 · Discontinued | $288.40 | $288.40 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $218.78 Median $218.78 Typical High $229.09 | Professional | 55 · Aftercare only | $218.78 | $218.78 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $144.54 Median $144.54 Typical High $151.36 | Professional | 56 · Pre-op care only | $144.54 | $144.54 | $151.36 |
Where South Dakota sits
The same service costs 21.9 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· 4th of 51
$1,738
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.