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 $61.66 Median $141.25 Typical High $4,365.16 | Facility | None | $61.66 | $141.25 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $95.50 Typical High $162.18 | Professional | None | $50.12 | $95.50 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $204.17 Typical High $251.19 | Facility | None | $66.07 | $204.17 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $173.78 Typical High $407.38 | Professional | None | $123.03 | $173.78 | $407.38 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $151.36 Typical High $223.87 | Facility | None | $85.11 | $151.36 | $223.87 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $354.81 Typical High $1,023.29 | Professional | None | $123.03 | $354.81 | $1,023.29 |
Midlands Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $316.23 | Professional | None | $144.54 | $144.54 | $316.23 |
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 $125.89 Median $125.89 Typical High $288.40 | Professional | None | $125.89 | $125.89 | $288.40 |
Sanford Health Plan Setting Professional Modifier None Typical Low $97.72 Median $162.18 Typical High $263.03 | Professional | None | $97.72 | $162.18 | $263.03 |
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 $74.13 Median $169.82 Typical High $398.11 | Professional | None | $74.13 | $169.82 | $398.11 |
Wellmark Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $302.00 | Professional | None | $95.50 | $112.20 | $302.00 |
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 $25.12 Median $45.71 Typical High $67.61 | Professional | 52 · Reduced service | $25.12 | $45.71 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $18.20 Typical High $27.54 | Professional | 53 · Discontinued | $10.00 | $18.20 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $37.15 Median $69.18 Typical High $102.33 | Professional | 54 · Surgery only | $37.15 | $69.18 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $13.80 Typical High $20.42 | Professional | 55 · Aftercare only | $7.41 | $13.80 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $9.12 Typical High $13.80 | Professional | 56 · Pre-op care only | $5.01 | $9.12 | $13.80 |
Where South Dakota sits
The same service costs 3.5 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· 6th 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.