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 $34.67 Median $102.33 Typical High $4,365.16 | Facility | None | $34.67 | $102.33 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $57.54 Typical High $109.65 | Professional | None | $28.18 | $57.54 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $147.91 Typical High $186.21 | Facility | None | $66.07 | $147.91 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $169.82 Typical High $295.12 | Professional | None | $69.18 | $169.82 | $295.12 |
Medica Setting Facility Modifier None Typical Low $47.86 Median $125.89 Typical High $223.87 | Facility | None | $47.86 | $125.89 | $223.87 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $208.93 Typical High $741.31 | Professional | None | $87.10 | $208.93 | $741.31 |
Midlands Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $223.87 | Professional | None | $81.28 | $81.28 | $223.87 |
Midlands Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Midlands Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $147.91 | Professional | None | $63.10 | $63.10 | $147.91 |
Sanford Health Plan Setting Professional Modifier None Typical Low $54.95 Median $114.82 Typical High $190.55 | Professional | None | $54.95 | $114.82 | $190.55 |
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 $41.69 Median $95.50 Typical High $281.84 | Professional | None | $41.69 | $95.50 | $281.84 |
Wellmark Setting Professional Modifier None Typical Low $54.95 Median $63.10 Typical High $223.87 | Professional | None | $54.95 | $63.10 | $223.87 |
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 $14.13 Median $26.30 Typical High $50.12 | Professional | 52 · Reduced service | $14.13 | $26.30 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.62 Median $10.47 Typical High $19.95 | Professional | 53 · Discontinued | $5.62 | $10.47 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $21.38 Median $38.90 Typical High $74.13 | Professional | 54 · Surgery only | $21.38 | $38.90 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $7.76 Typical High $14.79 | Professional | 55 · Aftercare only | $4.27 | $7.76 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.82 Median $5.25 Typical High $10.00 | Professional | 56 · Pre-op care only | $2.82 | $5.25 | $10.00 |
Where South Dakota sits
The same service costs 3.3 times more in Alaska 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· 6th of 51
$117
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.