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 $72.44 Median $154.88 Typical High $4,365.16 | Facility | None | $72.44 | $154.88 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $109.65 Typical High $154.88 | Professional | None | $58.88 | $109.65 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $223.87 Typical High $281.84 | Facility | None | $100.00 | $223.87 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $398.11 | Professional | None | $144.54 | $204.17 | $398.11 |
Medica Setting Facility Modifier None Typical Low $100.00 Median $151.36 Typical High $223.87 | Facility | None | $100.00 | $151.36 | $223.87 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $389.05 Typical High $1,122.02 | Professional | None | $134.90 | $389.05 | $1,122.02 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $346.74 | Professional | None | $169.82 | $169.82 | $346.74 |
Midlands Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Midlands Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $316.23 | Professional | None | $147.91 | $147.91 | $316.23 |
Sanford Health Plan Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $295.12 | Professional | None | $117.49 | $186.21 | $295.12 |
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 $87.10 Median $199.53 Typical High $436.52 | Professional | None | $87.10 | $199.53 | $436.52 |
Wellmark Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $338.84 | Professional | None | $114.82 | $131.83 | $338.84 |
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 $29.51 Median $54.95 Typical High $75.86 | Professional | 52 · Reduced service | $29.51 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $21.88 Typical High $30.20 | Professional | 53 · Discontinued | $11.75 | $21.88 | $30.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $83.18 Typical High $112.20 | Professional | 54 · Surgery only | $44.67 | $83.18 | $112.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $16.60 Typical High $22.91 | Professional | 55 · Aftercare only | $8.91 | $16.60 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $10.96 Typical High $15.14 | Professional | 56 · Pre-op care only | $5.89 | $10.96 | $15.14 |
Where South Dakota sits
The same service costs 3.5 times more in Alaska than in Maryland. 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
$191
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.