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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $93.33 | Professional | None | $89.13 | $89.13 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $123.03 Typical High $169.82 | Facility | None | $97.72 | $123.03 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $100.00 | Professional | None | $72.44 | $91.20 | $100.00 |
Medica Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $1,659.59 | Facility | None | $138.04 | $138.04 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $83.18 Typical High $190.55 | Professional | None | $70.79 | $83.18 | $190.55 |
Midlands Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Professional | None | $100.00 | $100.00 | $100.00 |
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 $89.13 Median $89.13 Typical High $89.13 | Facility | None | $89.13 | $89.13 | $89.13 |
Wellmark Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
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 $44.67 Median $44.67 Typical High $46.77 | Professional | 52 · Reduced service | $44.67 | $44.67 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $17.78 Typical High $18.62 | Professional | 53 · Discontinued | $17.78 | $17.78 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $13.49 Typical High $14.13 | Professional | 55 · Aftercare only | $13.49 | $13.49 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $8.91 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.91 | $8.91 | $9.33 |
Where South Dakota sits
The same service costs 17.4 times more in Wyoming than in Montana. 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· 43rd of 51
$91.20
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.