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 $16.22 Median $18.62 Typical High $4,365.16 | Facility | None | $16.22 | $18.62 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $15.49 Typical High $21.38 | Professional | None | $13.49 | $15.49 | $21.38 |
Cigna Setting Facility Modifier None Typical Low $9.12 Median $26.92 Typical High $33.88 | Facility | None | $9.12 | $26.92 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $40.74 Typical High $53.70 | Professional | None | $30.90 | $40.74 | $53.70 |
Medica Setting Facility Modifier None Typical Low $21.88 Median $26.30 Typical High $151.36 | Facility | None | $21.88 | $26.30 | $151.36 |
Medica Setting Professional Modifier None Typical Low $16.98 Median $38.90 Typical High $199.53 | Professional | None | $16.98 | $38.90 | $199.53 |
Midlands Setting Professional Modifier None Typical Low $35.48 Median $38.90 Typical High $43.65 | Professional | None | $35.48 | $38.90 | $43.65 |
Midlands Setting Facility Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Facility | None | $9.12 | $9.12 | $9.12 |
Midlands Setting Professional Modifier None Typical Low $33.88 Median $33.88 Typical High $38.02 | Professional | None | $33.88 | $33.88 | $38.02 |
Sanford Health Plan Setting Professional Modifier None Typical Low $21.88 Median $29.51 Typical High $35.48 | Professional | None | $21.88 | $29.51 | $35.48 |
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 $16.22 Median $33.11 Typical High $51.29 | Professional | None | $16.22 | $33.11 | $51.29 |
Wellmark Setting Professional Modifier None Typical Low $25.70 Median $30.20 Typical High $42.66 | Professional | None | $25.70 | $30.20 | $42.66 |
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 $6.76 Median $7.76 Typical High $10.96 | Professional | 52 · Reduced service | $6.76 | $7.76 | $10.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $3.09 Typical High $4.37 | Professional | 53 · Discontinued | $2.69 | $3.09 | $4.37 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $10.23 Median $11.75 Typical High $16.60 | Professional | 54 · Surgery only | $10.23 | $11.75 | $16.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.04 Median $2.34 Typical High $3.31 | Professional | 55 · Aftercare only | $2.04 | $2.34 | $3.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.35 Median $1.55 Typical High $2.19 | Professional | 56 · Pre-op care only | $1.35 | $1.55 | $2.19 |
Where South Dakota sits
The same service costs 3.9 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· 4th of 51
$33.88
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.