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 $120.23 Median $120.23 Typical High $120.23 | Facility | None | $120.23 | $120.23 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $141.25 Typical High $141.25 | Professional | None | $91.20 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $177.83 | Professional | None | $144.54 | $144.54 | $177.83 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $234.42 Typical High $234.42 | Facility | None | $144.54 | $234.42 | $234.42 |
Medica Setting Professional Modifier None Typical Low $44.67 Median $57.54 Typical High $707.95 | Professional | None | $44.67 | $57.54 | $707.95 |
Sanford Health Plan Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $173.78 | Professional | None | $144.54 | $144.54 | $173.78 |
United Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $70.79 | Professional | None | $41.69 | $44.67 | $70.79 |
Wellmark Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
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 $45.71 Median $70.79 Typical High $70.79 | Professional | 52 · Reduced service | $45.71 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $28.18 Typical High $28.18 | Professional | 53 · Discontinued | $18.20 | $28.18 | $28.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $20.89 Typical High $20.89 | Professional | 55 · Aftercare only | $13.80 | $20.89 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $14.13 Typical High $14.13 | Professional | 56 · Pre-op care only | $9.12 | $14.13 | $14.13 |
Where South Dakota sits
The same service costs 3.2 times more in Hawaii than in Arizona. 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· 13th of 51
$100
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.