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 $28.18 Median $57.54 Typical High $4,365.16 | Facility | None | $28.18 | $57.54 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $22.91 Median $41.69 Typical High $66.07 | Professional | None | $22.91 | $41.69 | $66.07 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $53.70 Typical High $109.65 | Facility | None | $39.81 | $53.70 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $147.91 | Professional | None | $54.95 | $77.62 | $147.91 |
Medica Setting Facility Modifier None Typical Low $38.90 Median $87.10 Typical High $151.36 | Facility | None | $38.90 | $87.10 | $151.36 |
Medica Setting Professional Modifier None Typical Low $50.12 Median $134.90 Typical High $446.68 | Professional | None | $50.12 | $134.90 | $446.68 |
Midlands Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $125.89 | Professional | None | $67.61 | $67.61 | $125.89 |
Midlands Setting Facility Modifier None Typical Low $39.81 Median $51.29 Typical High $61.66 | Facility | None | $39.81 | $51.29 | $61.66 |
Midlands Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $117.49 | Professional | None | $58.88 | $58.88 | $117.49 |
Sanford Health Plan Setting Professional Modifier None Typical Low $43.65 Median $67.61 Typical High $114.82 | Professional | None | $43.65 | $67.61 | $114.82 |
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 $33.88 Median $77.62 Typical High $158.49 | Professional | None | $33.88 | $77.62 | $158.49 |
Wellmark Setting Professional Modifier None Typical Low $47.86 Median $56.23 Typical High $134.90 | Professional | None | $47.86 | $56.23 | $134.90 |
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 $11.48 Median $20.89 Typical High $29.51 | Professional | 52 · Reduced service | $11.48 | $20.89 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.57 Median $8.32 Typical High $11.75 | Professional | 53 · Discontinued | $4.57 | $8.32 | $11.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.38 Median $31.62 Typical High $44.67 | Professional | 54 · Surgery only | $17.38 | $31.62 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.47 Median $6.31 Typical High $8.91 | Professional | 55 · Aftercare only | $3.47 | $6.31 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.29 Median $4.17 Typical High $5.89 | Professional | 56 · Pre-op care only | $2.29 | $4.17 | $5.89 |
Where South Dakota sits
The same service costs 3.3 times more in Alaska than in New Jersey. 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· 7th of 51
$77.62
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.