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 $177.83 Median $177.83 Typical High $177.83 | Facility | None | $177.83 | $177.83 | $177.83 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $229.09 | Professional | None | $181.97 | $208.93 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $309.03 | Professional | None | $245.47 | $245.47 | $309.03 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $346.74 Typical High $380.19 | Facility | None | $323.59 | $346.74 | $380.19 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $1,621.81 | Professional | None | $85.11 | $89.13 | $1,621.81 |
Sanford Health Plan Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $257.04 | Professional | None | $213.80 | $213.80 | $257.04 |
United Setting Professional Modifier None Typical Low $83.18 Median $85.11 Typical High $141.25 | Professional | None | $83.18 | $85.11 | $141.25 |
Wellmark Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
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 $89.13 Median $104.71 Typical High $114.82 | Professional | 52 · Reduced service | $89.13 | $104.71 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $41.69 Typical High $45.71 | Professional | 53 · Discontinued | $36.31 | $41.69 | $45.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.90 Typical High $34.67 | Professional | 55 · Aftercare only | $26.92 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.89 Typical High $22.91 | Professional | 56 · Pre-op care only | $18.20 | $20.89 | $22.91 |
Where South Dakota sits
The same service costs 3.3 times more in Alaska 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· 6th of 51
$229
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.