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 $56.23 Median $77.62 Typical High $4,365.16 | Facility | None | $56.23 | $77.62 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $107.15 | Professional | None | $46.77 | $69.18 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $47.86 Median $66.07 Typical High $151.36 | Facility | None | $47.86 | $66.07 | $151.36 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $147.91 Typical High $199.53 | Professional | None | $112.20 | $147.91 | $199.53 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $117.49 Typical High $199.53 | Facility | None | $74.13 | $117.49 | $199.53 |
Medica Setting Professional Modifier None Typical Low $74.13 Median $190.55 Typical High $616.60 | Professional | None | $74.13 | $190.55 | $616.60 |
Midlands Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $173.78 | Professional | None | $131.83 | $131.83 | $173.78 |
Midlands Setting Facility Modifier None Typical Low $47.86 Median $66.07 Typical High $83.18 | Facility | None | $47.86 | $66.07 | $83.18 |
Midlands Setting Professional Modifier None Typical Low $117.49 Median $125.89 Typical High $169.82 | Professional | None | $117.49 | $125.89 | $169.82 |
Sanford Health Plan Setting Professional Modifier None Typical Low $81.28 Median $109.65 Typical High $154.88 | Professional | None | $81.28 | $109.65 | $154.88 |
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 $66.07 Median $151.36 Typical High $218.78 | Professional | None | $66.07 | $151.36 | $218.78 |
Wellmark Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $223.87 | Professional | None | $107.15 | $125.89 | $223.87 |
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 $23.44 Median $34.67 Typical High $41.69 | Professional | 52 · Reduced service | $23.44 | $34.67 | $41.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $13.80 Typical High $16.60 | Professional | 53 · Discontinued | $9.33 | $13.80 | $16.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $52.48 Typical High $61.66 | Professional | 54 · Surgery only | $34.67 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $10.47 Typical High $12.59 | Professional | 55 · Aftercare only | $7.08 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $6.92 Typical High $8.32 | Professional | 56 · Pre-op care only | $4.68 | $6.92 | $8.32 |
Where South Dakota sits
The same service costs 3.4 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· 6th of 51
$129
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.