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 $23.44 Median $74.13 Typical High $4,365.16 | Facility | None | $23.44 | $74.13 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $34.67 Typical High $93.33 | Professional | None | $18.20 | $34.67 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $123.03 Typical High $154.88 | Facility | None | $48.98 | $123.03 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $138.04 Typical High $245.47 | Professional | None | $44.67 | $138.04 | $245.47 |
Medica Setting Facility Modifier None Typical Low $30.90 Median $120.23 Typical High $194.98 | Facility | None | $30.90 | $120.23 | $194.98 |
Medica Setting Professional Modifier None Typical Low $64.57 Median $154.88 Typical High $616.60 | Professional | None | $64.57 | $154.88 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $154.88 | Professional | None | $53.70 | $53.70 | $154.88 |
Midlands Setting Facility Modifier None Typical Low $48.98 Median $48.98 Typical High $48.98 | Facility | None | $48.98 | $48.98 | $48.98 |
Midlands Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $123.03 | Professional | None | $47.86 | $47.86 | $123.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $36.31 Median $85.11 Typical High $151.36 | Professional | None | $36.31 | $85.11 | $151.36 |
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 $28.18 Median $64.57 Typical High $208.93 | Professional | None | $28.18 | $64.57 | $208.93 |
Wellmark Setting Professional Modifier None Typical Low $38.90 Median $45.71 Typical High $186.21 | Professional | None | $38.90 | $45.71 | $186.21 |
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 $9.12 Median $17.38 Typical High $41.69 | Professional | 52 · Reduced service | $9.12 | $17.38 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $6.92 Typical High $16.60 | Professional | 53 · Discontinued | $3.63 | $6.92 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $13.80 Median $25.70 Typical High $61.66 | Professional | 54 · Surgery only | $13.80 | $25.70 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $5.13 Typical High $12.30 | Professional | 55 · Aftercare only | $2.75 | $5.13 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.82 Median $3.47 Typical High $8.32 | Professional | 56 · Pre-op care only | $1.82 | $3.47 | $8.32 |
Where South Dakota sits
The same service costs 3.4 times more in Wisconsin 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· 12th of 51
$81.28
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.