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 $93.33 Median $302.00 Typical High $4,365.16 | Facility | None | $93.33 | $302.00 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $93.33 Typical High $309.03 | Professional | None | $74.13 | $93.33 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $457.09 Typical High $575.44 | Facility | None | $331.13 | $457.09 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $912.01 | Professional | None | $199.53 | $281.84 | $912.01 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $446.68 Typical High $758.58 | Facility | None | $123.03 | $446.68 | $758.58 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $812.83 Typical High $1,071.52 | Professional | None | $257.04 | $812.83 | $1,071.52 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $645.65 | Professional | None | $218.78 | $218.78 | $645.65 |
Midlands Setting Facility Modifier None Typical Low $331.13 Median $338.84 Typical High $371.54 | Facility | None | $331.13 | $338.84 | $371.54 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $602.56 | Professional | None | $194.98 | $194.98 | $602.56 |
Sanford Health Plan Setting Professional Modifier None Typical Low $128.82 Median $295.12 Typical High $588.84 | Professional | None | $128.82 | $295.12 | $588.84 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $112.20 Median $263.03 Typical High $831.76 | Professional | None | $112.20 | $263.03 | $831.76 |
Wellmark Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $794.33 | Professional | None | $151.36 | $181.97 | $794.33 |
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 $37.15 Median $46.77 Typical High $154.88 | Professional | 52 · Reduced service | $37.15 | $46.77 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $18.62 Typical High $61.66 | Professional | 53 · Discontinued | $14.79 | $18.62 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $54.95 Median $70.79 Typical High $229.09 | Professional | 54 · Surgery only | $54.95 | $70.79 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.13 Typical High $45.71 | Professional | 55 · Aftercare only | $10.96 | $14.13 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.33 Typical High $30.90 | Professional | 56 · Pre-op care only | $7.41 | $9.33 | $30.90 |
Where South Dakota sits
The same service costs 4.3 times more in Oklahoma than in Nebraska. 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· 15th of 51
$347
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.