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 $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $67.61 | Professional | None | $61.66 | $61.66 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $120.23 | Professional | None | $97.72 | $97.72 | $120.23 |
Medica Setting Facility Modifier None Typical Low $97.72 Median $104.71 Typical High $112.20 | Facility | None | $97.72 | $104.71 | $112.20 |
Medica Setting Professional Modifier None Typical Low $25.12 Median $26.30 Typical High $416.87 | Professional | None | $25.12 | $26.30 | $416.87 |
Sanford Health Plan Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | None | $63.10 | $63.10 | $75.86 |
United Setting Professional Modifier None Typical Low $15.14 Median $25.12 Typical High $50.12 | Professional | None | $15.14 | $25.12 | $50.12 |
Wellmark Setting Professional Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | None | $69.18 | $69.18 | $69.18 |
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 $30.90 Median $30.90 Typical High $33.88 | Professional | 52 · Reduced service | $30.90 | $30.90 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $12.30 Typical High $13.49 | Professional | 53 · Discontinued | $12.30 | $12.30 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $9.12 Typical High $10.23 | Professional | 55 · Aftercare only | $9.12 | $9.12 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.17 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.17 | $6.17 | $6.76 |
Where South Dakota sits
The same service costs 4.2 times more in Minnesota than in Alaska. 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· 8th of 51
$64.57
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.