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 $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $954.99 | Professional | None | $912.01 | $912.01 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $676.08 Typical High $831.76 | Facility | None | $169.82 | $676.08 | $831.76 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $630.96 Typical High $776.25 | Professional | None | $501.19 | $630.96 | $776.25 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,659.59 | Facility | None | $1,096.48 | $1,096.48 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $1,513.56 | Professional | None | $489.78 | $645.65 | $1,513.56 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $776.25 | Professional | None | $776.25 | $776.25 | $776.25 |
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 $1,412.54 Median $1,412.54 Typical High $1,412.54 | Professional | None | $1,412.54 | $1,412.54 | $1,412.54 |
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 $912.01 Median $912.01 Typical High $912.01 | Facility | None | $912.01 | $912.01 | $912.01 |
Wellmark Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $912.01 | Professional | None | $912.01 | $912.01 | $912.01 |
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 $457.09 Median $457.09 Typical High $478.63 | Professional | 52 · Reduced service | $457.09 | $457.09 | $478.63 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $190.55 | Professional | 53 · Discontinued | $181.97 | $181.97 | $190.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 55 · Aftercare only | $138.04 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $95.50 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $95.50 |
Where South Dakota sits
The same service costs 12.0 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· 16th of 51
$646
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.