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 $14.45 Median $33.11 Typical High $4,365.16 | Facility | None | $14.45 | $33.11 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $11.75 Median $26.30 Typical High $34.67 | Professional | None | $11.75 | $26.30 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $25.12 Median $48.98 Typical High $61.66 | Facility | None | $25.12 | $48.98 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $40.74 Typical High $97.72 | Professional | None | $28.84 | $40.74 | $97.72 |
Medica Setting Facility Modifier None Typical Low $19.95 Median $47.86 Typical High $151.36 | Facility | None | $19.95 | $47.86 | $151.36 |
Medica Setting Professional Modifier None Typical Low $28.84 Median $81.28 Typical High $245.47 | Professional | None | $28.84 | $81.28 | $245.47 |
Midlands Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $75.86 | Professional | None | $34.67 | $34.67 | $75.86 |
Midlands Setting Facility Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Facility | None | $25.12 | $25.12 | $25.12 |
Midlands Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $67.61 | Professional | None | $30.20 | $30.20 | $67.61 |
Sanford Health Plan Setting Professional Modifier None Typical Low $23.44 Median $39.81 Typical High $64.57 | Professional | None | $23.44 | $39.81 | $64.57 |
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 $17.38 Median $40.74 Typical High $91.20 | Professional | None | $17.38 | $40.74 | $91.20 |
Wellmark Setting Professional Modifier None Typical Low $25.12 Median $28.84 Typical High $75.86 | Professional | None | $25.12 | $28.84 | $75.86 |
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 $5.89 Median $13.80 Typical High $16.98 | Professional | 52 · Reduced service | $5.89 | $13.80 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.34 Median $5.50 Typical High $6.76 | Professional | 53 · Discontinued | $2.34 | $5.50 | $6.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.91 Median $20.89 Typical High $25.12 | Professional | 54 · Surgery only | $8.91 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.78 Median $4.17 Typical High $5.13 | Professional | 55 · Aftercare only | $1.78 | $4.17 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.17 Median $2.75 Typical High $3.39 | Professional | 56 · Pre-op care only | $1.17 | $2.75 | $3.39 |
Where South Dakota sits
The same service costs 3.5 times more in Alaska than in New Jersey. 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· 10th of 51
$40.74
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.