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 $75.86 Median $162.18 Typical High $4,365.16 | Facility | None | $75.86 | $162.18 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $61.66 Median $114.82 Typical High $181.97 | Professional | None | $61.66 | $114.82 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $288.40 | Facility | None | $100.00 | $162.18 | $288.40 |
Cigna Setting Professional Modifier None Typical Low $151.36 Median $263.03 Typical High $457.09 | Professional | None | $151.36 | $263.03 | $457.09 |
Medica Setting Facility Modifier None Typical Low $102.33 Median $151.36 Typical High $229.09 | Facility | None | $102.33 | $151.36 | $229.09 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $398.11 Typical High $1,148.15 | Professional | None | $138.04 | $398.11 | $1,148.15 |
Midlands Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $363.08 | Professional | None | $177.83 | $177.83 | $363.08 |
Midlands Setting Facility Modifier None Typical Low $100.00 Median $162.18 Typical High $181.97 | Facility | None | $100.00 | $162.18 | $181.97 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $263.03 | Professional | None | $154.88 | $154.88 | $263.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $302.00 | Professional | None | $120.23 | $181.97 | $302.00 |
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 $91.20 Median $204.17 Typical High $446.68 | Professional | None | $91.20 | $204.17 | $446.68 |
Wellmark Setting Professional Modifier None Typical Low $120.23 Median $138.04 Typical High $346.74 | Professional | None | $120.23 | $138.04 | $346.74 |
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 $30.90 Median $57.54 Typical High $77.62 | Professional | 52 · Reduced service | $30.90 | $57.54 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $22.91 Typical High $30.90 | Professional | 53 · Discontinued | $12.30 | $22.91 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $85.11 Typical High $117.49 | Professional | 54 · Surgery only | $46.77 | $85.11 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $16.98 Typical High $23.44 | Professional | 55 · Aftercare only | $9.33 | $16.98 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $11.48 Typical High $15.49 | Professional | 56 · Pre-op care only | $6.17 | $11.48 | $15.49 |
Where South Dakota sits
The same service costs 3.2 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
$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.