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 $165.96 Median $213.80 Typical High $346.74 | Facility | None | $165.96 | $213.80 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $19.95 Median $37.15 Typical High $50.12 | Professional | None | $19.95 | $37.15 | $50.12 |
Cigna Setting Facility Modifier None Typical Low $30.20 Median $67.61 Typical High $83.18 | Facility | None | $30.20 | $67.61 | $83.18 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $67.61 Typical High $134.90 | Professional | None | $52.48 | $67.61 | $134.90 |
Medica Setting Facility Modifier None Typical Low $33.11 Median $64.57 Typical High $151.36 | Facility | None | $33.11 | $64.57 | $151.36 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $112.20 Typical High $338.84 | Professional | None | $41.69 | $112.20 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $104.71 | Professional | None | $58.88 | $58.88 | $104.71 |
Midlands Setting Facility Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Midlands Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $93.33 | Professional | None | $52.48 | $52.48 | $93.33 |
Sanford Health Plan Setting Professional Modifier None Typical Low $38.90 Median $61.66 Typical High $87.10 | Professional | None | $38.90 | $61.66 | $87.10 |
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 $29.51 Median $66.07 Typical High $125.89 | Professional | None | $29.51 | $66.07 | $125.89 |
Wellmark Setting Professional Modifier None Typical Low $42.66 Median $48.98 Typical High $102.33 | Professional | None | $42.66 | $48.98 | $102.33 |
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 $10.00 Median $19.05 Typical High $22.91 | Professional | 52 · Reduced service | $10.00 | $19.05 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.98 Median $7.76 Typical High $9.12 | Professional | 53 · Discontinued | $3.98 | $7.76 | $9.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $28.84 Typical High $34.67 | Professional | 54 · Surgery only | $14.79 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $5.75 Typical High $6.92 | Professional | 55 · Aftercare only | $2.95 | $5.75 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.00 Median $3.89 Typical High $4.57 | Professional | 56 · Pre-op care only | $2.00 | $3.89 | $4.57 |
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· 8th of 51
$66.07
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.