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 $54.95 Median $97.72 Typical High $4,365.16 | Facility | None | $54.95 | $97.72 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $87.10 Typical High $147.91 | Professional | None | $45.71 | $87.10 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $114.82 Typical High $186.21 | Facility | None | $87.10 | $114.82 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $169.82 Typical High $295.12 | Professional | None | $123.03 | $169.82 | $295.12 |
Medica Setting Facility Modifier None Typical Low $75.86 Median $125.89 Typical High $223.87 | Facility | None | $75.86 | $125.89 | $223.87 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $758.58 | Professional | None | $131.83 | $263.03 | $758.58 |
Midlands Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $223.87 | Professional | None | $128.82 | $128.82 | $223.87 |
Midlands Setting Facility Modifier None Typical Low $85.11 Median $102.33 Typical High $120.23 | Facility | None | $85.11 | $102.33 | $120.23 |
Midlands Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $204.17 | Professional | None | $114.82 | $114.82 | $204.17 |
Sanford Health Plan Setting Professional Modifier None Typical Low $87.10 Median $144.54 Typical High $208.93 | Professional | None | $87.10 | $144.54 | $208.93 |
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 $154.88 Typical High $275.42 | Professional | None | $81.28 | $154.88 | $275.42 |
Wellmark Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $229.09 | Professional | None | $87.10 | $104.71 | $229.09 |
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 $22.39 Median $27.54 Typical High $50.12 | Professional | 52 · Reduced service | $22.39 | $27.54 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $10.96 Typical High $19.95 | Professional | 53 · Discontinued | $9.12 | $10.96 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $41.69 Typical High $74.13 | Professional | 54 · Surgery only | $33.88 | $41.69 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $8.32 Typical High $14.79 | Professional | 55 · Aftercare only | $6.76 | $8.32 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.47 Median $5.50 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.47 | $5.50 | $10.00 |
Where South Dakota sits
The same service costs 2.8 times more in Alaska than in Pennsylvania. 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· 10th of 51
$148
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.