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 $67.61 Median $154.88 Typical High $4,365.16 | Facility | None | $67.61 | $154.88 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $125.89 Typical High $154.88 | Professional | None | $54.95 | $125.89 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $323.59 Typical High $954.99 | Facility | None | $213.80 | $323.59 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $426.58 | Professional | None | $147.91 | $208.93 | $426.58 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $213.80 Typical High $1,202.26 | Facility | None | $93.33 | $213.80 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $407.38 Typical High $1,096.48 | Professional | None | $134.90 | $407.38 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $338.84 | Professional | None | $154.88 | $154.88 | $338.84 |
Midlands Setting Facility Modifier None Typical Low $323.59 Median $645.65 Typical High $1,000.00 | Facility | None | $323.59 | $645.65 | $1,000.00 |
Midlands Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $309.03 | Professional | None | $144.54 | $144.54 | $309.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $281.84 | Professional | None | $112.20 | $186.21 | $281.84 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $79.43 Median $186.21 Typical High $426.58 | Professional | None | $79.43 | $186.21 | $426.58 |
Wellmark Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $371.54 | Professional | None | $114.82 | $141.25 | $371.54 |
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 $27.54 Median $33.88 Typical High $70.79 | Professional | 52 · Reduced service | $27.54 | $33.88 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.49 Typical High $28.84 | Professional | 53 · Discontinued | $10.96 | $13.49 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $51.29 Typical High $107.15 | Professional | 54 · Surgery only | $40.74 | $51.29 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $10.23 Typical High $21.38 | Professional | 55 · Aftercare only | $8.13 | $10.23 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.76 Typical High $14.45 | Professional | 56 · Pre-op care only | $5.50 | $6.76 | $14.45 |
Where South Dakota sits
The same service costs 4.9 times more in Alaska than in Hawaii. 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· 12th of 51
$209
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.