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 $66.07 Median $144.54 Typical High $4,365.16 | Facility | None | $66.07 | $144.54 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $95.50 Typical High $147.91 | Professional | None | $52.48 | $95.50 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $141.25 Typical High $257.04 | Facility | None | $66.07 | $141.25 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $229.09 Typical High $371.54 | Professional | None | $125.89 | $229.09 | $371.54 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $151.36 Typical High $223.87 | Facility | None | $87.10 | $151.36 | $223.87 |
Medica Setting Professional Modifier None Typical Low $125.89 Median $354.81 Typical High $1,023.29 | Professional | None | $125.89 | $354.81 | $1,023.29 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $331.13 | Professional | None | $154.88 | $154.88 | $331.13 |
Midlands Setting Facility Modifier None Typical Low $66.07 Median $134.90 Typical High $162.18 | Facility | None | $66.07 | $134.90 | $162.18 |
Midlands Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $239.88 | Professional | None | $134.90 | $134.90 | $239.88 |
Sanford Health Plan Setting Professional Modifier None Typical Low $102.33 Median $165.96 Typical High $263.03 | Professional | None | $102.33 | $165.96 | $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 $79.43 Median $181.97 Typical High $407.38 | Professional | None | $79.43 | $181.97 | $407.38 |
Wellmark Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $302.00 | Professional | None | $102.33 | $117.49 | $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 $26.30 Median $47.86 Typical High $67.61 | Professional | 52 · Reduced service | $26.30 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $19.05 Typical High $27.54 | Professional | 53 · Discontinued | $10.47 | $19.05 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $70.79 Typical High $102.33 | Professional | 54 · Surgery only | $38.90 | $70.79 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $14.13 Typical High $20.42 | Professional | 55 · Aftercare only | $7.76 | $14.13 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $9.55 Typical High $13.80 | Professional | 56 · Pre-op care only | $5.25 | $9.55 | $13.80 |
Where South Dakota sits
The same service costs 3.1 times more in Wisconsin 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
$174
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.