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 $104.71 Median $104.71 Typical High $104.71 | Facility | None | $104.71 | $104.71 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $123.03 Typical High $123.03 | Professional | None | $114.82 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $213.80 | Professional | None | $169.82 | $169.82 | $213.80 |
Medica Setting Facility Modifier None Typical Low $173.78 Median $208.93 Typical High $208.93 | Facility | None | $173.78 | $208.93 | $208.93 |
Medica Setting Professional Modifier None Typical Low $50.12 Median $52.48 Typical High $794.33 | Professional | None | $50.12 | $52.48 | $794.33 |
Sanford Health Plan Setting Professional Modifier None Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | None | $125.89 | $125.89 | $151.36 |
United Setting Professional Modifier None Typical Low $48.98 Median $50.12 Typical High $75.86 | Professional | None | $48.98 | $50.12 | $75.86 |
Wellmark Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
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 $57.54 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $57.54 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $22.91 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $18.20 Typical High $18.20 | Professional | 55 · Aftercare only | $16.98 | $18.20 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $11.48 | $12.30 | $12.30 |
Where South Dakota sits
The same service costs 2.5 times more in Minnesota than in Utah. 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· 9th of 51
$120
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.