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 $58.88 Median $154.88 Typical High $4,365.16 | Facility | None | $58.88 | $154.88 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $87.10 Typical High $158.49 | Professional | None | $46.77 | $87.10 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $229.09 Typical High $288.40 | Facility | None | $154.88 | $229.09 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $162.18 Typical High $407.38 | Professional | None | $114.82 | $162.18 | $407.38 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $229.09 Typical High $758.58 | Facility | None | $79.43 | $229.09 | $758.58 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $338.84 Typical High $549.54 | Professional | None | $138.04 | $338.84 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $338.84 | Professional | None | $138.04 | $138.04 | $338.84 |
Midlands Setting Facility Modifier None Typical Low $154.88 Median $169.82 Typical High $186.21 | Facility | None | $154.88 | $169.82 | $186.21 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $309.03 | Professional | None | $123.03 | $123.03 | $309.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $81.28 Median $151.36 Typical High $288.40 | Professional | None | $81.28 | $151.36 | $288.40 |
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 $70.79 Median $165.96 Typical High $426.58 | Professional | None | $70.79 | $165.96 | $426.58 |
Wellmark Setting Professional Modifier None Typical Low $91.20 Median $107.15 Typical High $346.74 | Professional | None | $91.20 | $107.15 | $346.74 |
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 $23.44 Median $43.65 Typical High $77.62 | Professional | 52 · Reduced service | $23.44 | $43.65 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $17.38 Typical High $30.90 | Professional | 53 · Discontinued | $9.33 | $17.38 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $64.57 Typical High $114.82 | Professional | 54 · Surgery only | $35.48 | $64.57 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $12.88 Typical High $22.91 | Professional | 55 · Aftercare only | $7.08 | $12.88 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $8.71 Typical High $15.49 | Professional | 56 · Pre-op care only | $4.68 | $8.71 | $15.49 |
Where South Dakota sits
The same service costs 2.6 times more in Alaska than in Montana. 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· 13th of 51
$170
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.