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 $489.78 Median $489.78 Typical High $489.78 | Facility | None | $489.78 | $489.78 | $489.78 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $575.44 Typical High $575.44 | Professional | None | $478.63 | $575.44 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $831.76 | Professional | None | $676.08 | $676.08 | $831.76 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $977.24 Typical High $977.24 | Facility | None | $407.38 | $977.24 | $977.24 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $234.42 Typical High $2,951.21 | Professional | None | $186.21 | $234.42 | $2,951.21 |
Sanford Health Plan Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $707.95 | Professional | None | $588.84 | $588.84 | $707.95 |
United Setting Professional Modifier None Typical Low $173.78 Median $186.21 Typical High $295.12 | Professional | None | $173.78 | $186.21 | $295.12 |
Wellmark Setting Professional Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,479.11 | Professional | None | $1,479.11 | $1,479.11 | $1,479.11 |
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 $239.88 Median $288.40 Typical High $288.40 | Professional | 52 · Reduced service | $239.88 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $114.82 Typical High $114.82 | Professional | 53 · Discontinued | $95.50 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $85.11 Typical High $85.11 | Professional | 55 · Aftercare only | $72.44 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $57.54 Typical High $57.54 | Professional | 56 · Pre-op care only | $47.86 | $57.54 | $57.54 |
Where South Dakota sits
The same service costs 2.8 times more in Montana 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· 3rd of 51
$589
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.