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 $25.70 Median $33.88 Typical High $4,365.16 | Facility | None | $25.70 | $33.88 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $20.42 Median $26.92 Typical High $33.88 | Professional | None | $20.42 | $26.92 | $33.88 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $58.88 Typical High $79.43 | Facility | None | $47.86 | $58.88 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $50.12 Median $69.18 Typical High $95.50 | Professional | None | $50.12 | $69.18 | $95.50 |
Medica Setting Facility Modifier None Typical Low $34.67 Median $45.71 Typical High $151.36 | Facility | None | $34.67 | $45.71 | $151.36 |
Medica Setting Professional Modifier None Typical Low $38.02 Median $79.43 Typical High $2,187.76 | Professional | None | $38.02 | $79.43 | $2,187.76 |
Midlands Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $79.43 | Professional | None | $58.88 | $58.88 | $79.43 |
Midlands Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Midlands Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $70.79 | Professional | None | $52.48 | $52.48 | $70.79 |
Sanford Health Plan Setting Professional Modifier None Typical Low $35.48 Median $47.86 Typical High $63.10 | Professional | None | $35.48 | $47.86 | $63.10 |
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 $28.84 Median $52.48 Typical High $93.33 | Professional | None | $28.84 | $52.48 | $93.33 |
Wellmark Setting Professional Modifier None Typical Low $43.65 Median $50.12 Typical High $77.62 | Professional | None | $43.65 | $50.12 | $77.62 |
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 $10.23 Median $13.49 Typical High $16.98 | Professional | 52 · Reduced service | $10.23 | $13.49 | $16.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.07 Median $5.37 Typical High $6.76 | Professional | 53 · Discontinued | $4.07 | $5.37 | $6.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $15.14 Median $20.42 Typical High $25.70 | Professional | 54 · Surgery only | $15.14 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.09 Median $4.07 Typical High $5.13 | Professional | 55 · Aftercare only | $3.09 | $4.07 | $5.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.04 Median $2.69 Typical High $3.39 | Professional | 56 · Pre-op care only | $2.04 | $2.69 | $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· 5th of 51
$58.88
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.