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 $147.91 Median $147.91 Typical High $147.91 | Facility | None | $147.91 | $147.91 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $173.78 | Professional | None | $151.36 | $173.78 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $257.04 | Professional | None | $204.17 | $204.17 | $257.04 |
Medica Setting Facility Modifier None Typical Low $245.47 Median $288.40 Typical High $288.40 | Facility | None | $245.47 | $288.40 | $288.40 |
Medica Setting Professional Modifier None Typical Low $70.79 Median $72.44 Typical High $1,778.28 | Professional | None | $70.79 | $72.44 | $1,778.28 |
Sanford Health Plan Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $213.80 | Professional | None | $177.83 | $177.83 | $213.80 |
United Setting Professional Modifier None Typical Low $15.14 Median $70.79 Typical High $95.50 | Professional | None | $15.14 | $70.79 | $95.50 |
Wellmark Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | None | $154.88 | $154.88 | $154.88 |
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 $74.13 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $74.13 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $34.67 Typical High $34.67 | Professional | 53 · Discontinued | $30.20 | $34.67 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $22.39 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $17.38 Typical High $17.38 | Professional | 56 · Pre-op care only | $15.14 | $17.38 | $17.38 |
Where South Dakota sits
The same service costs 5.0 times more in Hawaii than in Florida. 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· 10th of 51
$155
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.