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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier None Typical Low $1,318.26 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,318.26 | $1,949.84 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,511.89 | Professional | None | $1,995.26 | $1,995.26 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $1,047.13 Median $3,311.31 Typical High $3,311.31 | Facility | None | $1,047.13 | $3,311.31 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $10,232.93 | Professional | None | $645.65 | $794.33 | $10,232.93 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,454.71 | Professional | None | $1,995.26 | $1,995.26 | $2,454.71 |
United Setting Professional Modifier None Typical Low $602.56 Median $645.65 Typical High $1,000.00 | Professional | None | $602.56 | $645.65 | $1,000.00 |
Wellmark Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
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 $660.69 Median $977.24 Typical High $977.24 | Professional | 52 · Reduced service | $660.69 | $977.24 | $977.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $263.03 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $295.12 Typical High $295.12 | Professional | 55 · Aftercare only | $194.98 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $131.83 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $131.83 | $194.98 | $194.98 |
Where South Dakota sits
The same service costs 2.7 times more in Montana than in New Jersey. 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
$1,995
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.