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 $46.77 Median $117.49 Typical High $4,365.16 | Facility | None | $46.77 | $117.49 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $74.13 Typical High $138.04 | Professional | None | $38.02 | $74.13 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $128.82 Typical High $213.80 | Facility | None | $66.07 | $128.82 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $128.82 Typical High $302.00 | Professional | None | $91.20 | $128.82 | $302.00 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $125.89 Typical High $223.87 | Facility | None | $64.57 | $125.89 | $223.87 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $257.04 Typical High $851.14 | Professional | None | $100.00 | $257.04 | $851.14 |
Midlands Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $257.04 | Professional | None | $109.65 | $109.65 | $257.04 |
Midlands Setting Facility Modifier None Typical Low $66.07 Median $125.89 Typical High $134.90 | Facility | None | $66.07 | $125.89 | $134.90 |
Midlands Setting Professional Modifier None Typical Low $91.20 Median $91.20 Typical High $181.97 | Professional | None | $91.20 | $91.20 | $181.97 |
Sanford Health Plan Setting Professional Modifier None Typical Low $74.13 Median $131.83 Typical High $218.78 | Professional | None | $74.13 | $131.83 | $218.78 |
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 $56.23 Median $128.82 Typical High $323.59 | Professional | None | $56.23 | $128.82 | $323.59 |
Wellmark Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $257.04 | Professional | None | $72.44 | $83.18 | $257.04 |
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 $19.05 Median $34.67 Typical High $57.54 | Professional | 52 · Reduced service | $19.05 | $34.67 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $13.80 Typical High $22.91 | Professional | 53 · Discontinued | $7.59 | $13.80 | $22.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $52.48 Typical High $87.10 | Professional | 54 · Surgery only | $28.18 | $52.48 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $10.47 Typical High $17.38 | Professional | 55 · Aftercare only | $5.75 | $10.47 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $6.92 Typical High $11.48 | Professional | 56 · Pre-op care only | $3.80 | $6.92 | $11.48 |
Where South Dakota sits
The same service costs 3.5 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
$129
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.