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 $50.12 Median $60.26 Typical High $4,365.16 | Facility | None | $50.12 | $60.26 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $51.29 Typical High $66.07 | Professional | None | $41.69 | $51.29 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $109.65 | Facility | None | $87.10 | $87.10 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $100.00 Median $138.04 Typical High $173.78 | Professional | None | $100.00 | $138.04 | $173.78 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $85.11 Typical High $223.87 | Facility | None | $70.79 | $85.11 | $223.87 |
Medica Setting Professional Modifier None Typical Low $64.57 Median $158.49 Typical High $371.54 | Professional | None | $64.57 | $158.49 | $371.54 |
Midlands Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $138.04 | Professional | None | $117.49 | $117.49 | $138.04 |
Midlands Setting Professional Modifier None Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | None | $102.33 | $102.33 | $123.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $70.79 Median $93.33 Typical High $117.49 | Professional | None | $70.79 | $93.33 | $117.49 |
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 $57.54 Median $131.83 Typical High $165.96 | Professional | None | $57.54 | $131.83 | $165.96 |
Wellmark Setting Professional Modifier None Typical Low $81.28 Median $100.00 Typical High $138.04 | Professional | None | $81.28 | $100.00 | $138.04 |
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 $20.89 Median $24.55 Typical High $29.51 | Professional | 52 · Reduced service | $20.89 | $24.55 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $10.00 Typical High $11.75 | Professional | 53 · Discontinued | $8.32 | $10.00 | $11.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $37.15 Typical High $43.65 | Professional | 54 · Surgery only | $30.90 | $37.15 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $7.41 Typical High $8.91 | Professional | 55 · Aftercare only | $6.17 | $7.41 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.01 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.17 | $5.01 | $5.89 |
Where South Dakota sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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
$112
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.