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 $83.18 Median $288.40 Typical High $4,365.16 | Facility | None | $83.18 | $288.40 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $83.18 Typical High $234.42 | Professional | None | $58.88 | $83.18 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $354.81 Typical High $436.52 | Facility | None | $354.81 | $354.81 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $398.11 Typical High $691.83 | Professional | None | $158.49 | $398.11 | $691.83 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $151.36 Typical High $338.84 | Facility | None | $100.00 | $151.36 | $338.84 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $758.58 Typical High $831.76 | Professional | None | $245.47 | $758.58 | $831.76 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $645.65 | Professional | None | $194.98 | $194.98 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $575.44 | Professional | None | $169.82 | $169.82 | $575.44 |
Sanford Health Plan Setting Professional Modifier None Typical Low $104.71 Median $229.09 Typical High $457.09 | Professional | None | $104.71 | $229.09 | $457.09 |
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 $97.72 Median $229.09 Typical High $794.33 | Professional | None | $97.72 | $229.09 | $794.33 |
Wellmark Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $537.03 | Professional | None | $123.03 | $151.36 | $537.03 |
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 $29.51 Median $41.69 Typical High $117.49 | Professional | 52 · Reduced service | $29.51 | $41.69 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $16.60 Typical High $46.77 | Professional | 53 · Discontinued | $11.75 | $16.60 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $61.66 Typical High $177.83 | Professional | 54 · Surgery only | $43.65 | $61.66 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.59 Typical High $35.48 | Professional | 55 · Aftercare only | $8.71 | $12.59 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.32 Typical High $23.44 | Professional | 56 · Pre-op care only | $5.89 | $8.32 | $23.44 |
Where South Dakota sits
The same service costs 4.5 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· 25th of 51
$245
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.