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 $97.72 Median $186.21 Typical High $4,365.16 | Facility | None | $97.72 | $186.21 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $128.82 Typical High $186.21 | Professional | None | $79.43 | $128.82 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $181.97 Typical High $331.13 | Facility | None | $100.00 | $181.97 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $537.03 | Professional | None | $204.17 | $275.42 | $537.03 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $263.03 | Facility | None | $125.89 | $151.36 | $263.03 |
Medica Setting Professional Modifier None Typical Low $162.18 Median $457.09 Typical High $1,348.96 | Professional | None | $162.18 | $457.09 | $1,348.96 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $426.58 | Professional | None | $229.09 | $229.09 | $426.58 |
Midlands Setting Facility Modifier None Typical Low $100.00 Median $177.83 Typical High $199.53 | Facility | None | $100.00 | $177.83 | $199.53 |
Midlands Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $380.19 | Professional | None | $204.17 | $204.17 | $380.19 |
Sanford Health Plan Setting Professional Modifier None Typical Low $154.88 Median $223.87 Typical High $346.74 | Professional | None | $154.88 | $223.87 | $346.74 |
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 $117.49 Median $263.03 Typical High $524.81 | Professional | None | $117.49 | $263.03 | $524.81 |
Wellmark Setting Professional Modifier None Typical Low $154.88 Median $177.83 Typical High $407.38 | Professional | None | $154.88 | $177.83 | $407.38 |
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 $39.81 Median $74.13 Typical High $89.13 | Professional | 52 · Reduced service | $39.81 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $29.51 Typical High $36.31 | Professional | 53 · Discontinued | $15.85 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $109.65 Typical High $134.90 | Professional | 54 · Surgery only | $60.26 | $109.65 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $21.88 Typical High $26.92 | Professional | 55 · Aftercare only | $12.02 | $21.88 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $14.79 Typical High $18.20 | Professional | 56 · Pre-op care only | $7.94 | $14.79 | $18.20 |
Where South Dakota sits
The same service costs 3.3 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· 7th of 51
$229
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.