How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $398.11 Median $2,290.87 Typical High $4,365.16 | Facility | None | $398.11 | $2,290.87 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $87.10 Typical High $97.72 | Professional | None | $61.66 | $87.10 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $147.91 Typical High $181.97 | Facility | None | $74.13 | $147.91 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $138.04 | Professional | None | $72.44 | $104.71 | $138.04 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $131.83 Typical High $223.87 | Facility | None | $107.15 | $131.83 | $223.87 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $263.03 Typical High $501.19 | Professional | None | $97.72 | $263.03 | $501.19 |
Midlands Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $138.04 | Professional | None | $91.20 | $91.20 | $138.04 |
Midlands Setting Facility Modifier None Typical Low $74.13 Median $87.10 Typical High $141.25 | Facility | None | $74.13 | $87.10 | $141.25 |
Sanford Health Plan Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $190.55 | Professional | None | $95.50 | $125.89 | $190.55 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $81.28 Median $158.49 Typical High $302.00 | Professional | None | $81.28 | $158.49 | $302.00 |
Wellmark Setting Professional Modifier None Typical Low $77.62 Median $81.28 Typical High $144.54 | Professional | None | $77.62 | $81.28 | $144.54 |
5 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 $30.90 Median $31.62 Typical High $48.98 | Professional | 52 · Reduced service | $30.90 | $31.62 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $12.88 Typical High $19.50 | Professional | 53 · Discontinued | $12.59 | $12.88 | $19.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $64.57 Typical High $74.13 | Professional | 54 · Surgery only | $46.77 | $64.57 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $9.55 Typical High $14.79 | Professional | 55 · Aftercare only | $9.33 | $9.55 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $6.46 Typical High $9.77 | Professional | 56 · Pre-op care only | $6.17 | $6.46 | $9.77 |
Where South Dakota sits
The same service costs 3.4 times more in Alaska than in Virginia. 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· 22nd of 51
$126
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.