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 $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $81.28 Typical High $81.28 | Professional | None | $60.26 | $81.28 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $104.71 | Professional | None | $83.18 | $83.18 | $104.71 |
Medica Setting Facility Modifier None Typical Low $51.29 Median $134.90 Typical High $134.90 | Facility | None | $51.29 | $134.90 | $134.90 |
Medica Setting Professional Modifier None Typical Low $30.20 Median $33.11 Typical High $446.68 | Professional | None | $30.20 | $33.11 | $446.68 |
Sanford Health Plan Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $100.00 | Professional | None | $83.18 | $83.18 | $100.00 |
United Setting Professional Modifier None Typical Low $12.88 Median $30.20 Typical High $46.77 | Professional | None | $12.88 | $30.20 | $46.77 |
Wellmark Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
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 $30.20 Median $40.74 Typical High $40.74 | Professional | 52 · Reduced service | $30.20 | $40.74 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $16.22 Typical High $16.22 | Professional | 53 · Discontinued | $12.30 | $16.22 | $16.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.02 Typical High $12.02 | Professional | 55 · Aftercare only | $9.12 | $12.02 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.13 Typical High $8.13 | Professional | 56 · Pre-op care only | $6.03 | $8.13 | $8.13 |
Where South Dakota sits
The same service costs 2.9 times more in Hawaii than in Indiana. 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· 15th of 51
$61.66
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.