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 $93.33 Median $144.54 Typical High $4,365.16 | Facility | None | $93.33 | $144.54 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $123.03 Typical High $158.49 | Professional | None | $75.86 | $123.03 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $114.82 Typical High $263.03 | Facility | None | $93.33 | $114.82 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $257.04 Typical High $416.87 | Professional | None | $181.97 | $257.04 | $416.87 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $208.93 Typical High $549.54 | Facility | None | $128.82 | $208.93 | $549.54 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $354.81 Typical High $1,071.52 | Professional | None | $138.04 | $354.81 | $1,071.52 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $331.13 | Professional | None | $213.80 | $213.80 | $331.13 |
Midlands Setting Facility Modifier None Typical Low $93.33 Median $112.20 Typical High $125.89 | Facility | None | $93.33 | $112.20 | $125.89 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $302.00 | Professional | None | $194.98 | $194.98 | $302.00 |
Sanford Health Plan Setting Professional Modifier None Typical Low $141.25 Median $199.53 Typical High $281.84 | Professional | None | $141.25 | $199.53 | $281.84 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $109.65 Median $218.78 Typical High $398.11 | Professional | None | $109.65 | $218.78 | $398.11 |
Wellmark Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $338.84 | Professional | None | $158.49 | $181.97 | $338.84 |
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 $38.02 Median $61.66 Typical High $70.79 | Professional | 52 · Reduced service | $38.02 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $24.55 Typical High $28.18 | Professional | 53 · Discontinued | $15.14 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $91.20 Typical High $104.71 | Professional | 54 · Surgery only | $56.23 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $18.20 Typical High $20.89 | Professional | 55 · Aftercare only | $11.48 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $12.30 Typical High $14.13 | Professional | 56 · Pre-op care only | $7.59 | $12.30 | $14.13 |
Where South Dakota sits
The same service costs 3.2 times more in Alaska than in Florida. 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
$214
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.