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 $407.38 Median $407.38 Typical High $407.38 | Facility | None | $407.38 | $407.38 | $407.38 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $478.63 Typical High $478.63 | Professional | None | $316.23 | $478.63 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $524.81 | Professional | None | $426.58 | $426.58 | $524.81 |
Medica Setting Facility Modifier None Typical Low $331.13 Median $812.83 Typical High $812.83 | Facility | None | $331.13 | $812.83 | $812.83 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $194.98 Typical High $2,398.83 | Professional | None | $151.36 | $194.98 | $2,398.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $588.84 | Professional | None | $489.78 | $489.78 | $588.84 |
United Setting Professional Modifier None Typical Low $141.25 Median $151.36 Typical High $245.47 | Professional | None | $141.25 | $151.36 | $245.47 |
Wellmark Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $549.54 | Professional | None | $549.54 | $549.54 | $549.54 |
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 $169.82 Median $239.88 Typical High $239.88 | Professional | 52 · Reduced service | $169.82 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $95.50 Typical High $95.50 | Professional | 53 · Discontinued | $67.61 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $70.79 Typical High $70.79 | Professional | 55 · Aftercare only | $51.29 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $47.86 Typical High $47.86 | Professional | 56 · Pre-op care only | $33.88 | $47.86 | $47.86 |
Where South Dakota sits
The same service costs 4.4 times more in Hawaii 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
$479
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.