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 $269.15 Median $575.44 Typical High $2,238.72 | Facility | None | $269.15 | $575.44 | $2,238.72 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $54.95 Typical High $112.20 | Professional | None | $37.15 | $54.95 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $50.12 Typical High $117.49 | Facility | None | $35.48 | $50.12 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $114.82 Typical High $158.49 | Professional | None | $89.13 | $114.82 | $158.49 |
Medica Setting Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $223.87 | Facility | None | $63.10 | $93.33 | $223.87 |
Medica Setting Professional Modifier None Typical Low $69.18 Median $162.18 Typical High $478.63 | Professional | None | $69.18 | $162.18 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $134.90 | Professional | None | $104.71 | $104.71 | $134.90 |
Midlands Setting Facility Modifier None Typical Low $35.48 Median $47.86 Typical High $63.10 | Facility | None | $35.48 | $47.86 | $63.10 |
Midlands Setting Professional Modifier None Typical Low $95.50 Median $102.33 Typical High $131.83 | Professional | None | $95.50 | $102.33 | $131.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $66.07 Median $87.10 Typical High $120.23 | Professional | None | $66.07 | $87.10 | $120.23 |
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 $53.70 Median $117.49 Typical High $169.82 | Professional | None | $53.70 | $117.49 | $169.82 |
Wellmark Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $173.78 | Professional | None | $87.10 | $102.33 | $173.78 |
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 $18.62 Median $27.54 Typical High $32.36 | Professional | 52 · Reduced service | $18.62 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $10.96 Typical High $12.88 | Professional | 53 · Discontinued | $7.59 | $10.96 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.18 Median $41.69 Typical High $48.98 | Professional | 54 · Surgery only | $28.18 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $8.32 Typical High $9.77 | Professional | 55 · Aftercare only | $5.62 | $8.32 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $5.50 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.72 | $5.50 | $6.46 |
Where South Dakota sits
The same service costs 4.2 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· 6th of 51
$105
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.