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 $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $85.11 Typical High $85.11 | Professional | None | $70.79 | $85.11 | $85.11 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $165.96 | Professional | None | $134.90 | $134.90 | $165.96 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $144.54 Typical High $144.54 | Facility | None | $60.26 | $144.54 | $144.54 |
Medica Setting Professional Modifier None Typical Low $34.67 Median $36.31 Typical High $562.34 | Professional | None | $34.67 | $36.31 | $562.34 |
Sanford Health Plan Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $107.15 | Professional | None | $87.10 | $87.10 | $107.15 |
United Setting Professional Modifier None Typical Low $10.96 Median $34.67 Typical High $45.71 | Professional | None | $10.96 | $34.67 | $45.71 |
Wellmark Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
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 $35.48 Median $42.66 Typical High $42.66 | Professional | 52 · Reduced service | $35.48 | $42.66 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $17.38 Typical High $17.38 | Professional | 53 · Discontinued | $14.13 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.88 Typical High $12.88 | Professional | 55 · Aftercare only | $10.72 | $12.88 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.51 Typical High $8.51 | Professional | 56 · Pre-op care only | $7.08 | $8.51 | $8.51 |
Where South Dakota sits
The same service costs 3.2 times more in Hawaii than in New York. 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· 25th of 51
$72.44
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.