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 $41.69 Median $61.66 Typical High $4,365.16 | Facility | None | $41.69 | $61.66 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $53.70 Typical High $77.62 | Professional | None | $33.88 | $53.70 | $77.62 |
Cigna Setting Facility Modifier None Typical Low $41.69 Median $54.95 Typical High $120.23 | Facility | None | $41.69 | $54.95 | $120.23 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $117.49 Typical High $158.49 | Professional | None | $81.28 | $117.49 | $158.49 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $93.33 Typical High $158.49 | Facility | None | $57.54 | $93.33 | $158.49 |
Medica Setting Professional Modifier None Typical Low $56.23 Median $147.91 Typical High $588.84 | Professional | None | $56.23 | $147.91 | $588.84 |
Midlands Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $138.04 | Professional | None | $95.50 | $95.50 | $138.04 |
Midlands Setting Facility Modifier None Typical Low $41.69 Median $54.95 Typical High $67.61 | Facility | None | $41.69 | $54.95 | $67.61 |
Midlands Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $134.90 | Professional | None | $85.11 | $93.33 | $134.90 |
Sanford Health Plan Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $120.23 | Professional | None | $64.57 | $79.43 | $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 $48.98 Median $109.65 Typical High $173.78 | Professional | None | $48.98 | $109.65 | $173.78 |
Wellmark Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $173.78 | Professional | None | $79.43 | $93.33 | $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 $16.98 Median $27.54 Typical High $33.11 | Professional | 52 · Reduced service | $16.98 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $11.22 Typical High $13.18 | Professional | 53 · Discontinued | $6.92 | $11.22 | $13.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $41.69 Typical High $50.12 | Professional | 54 · Surgery only | $25.70 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $8.32 Typical High $10.00 | Professional | 55 · Aftercare only | $5.13 | $8.32 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $5.62 Typical High $6.61 | Professional | 56 · Pre-op care only | $3.39 | $5.62 | $6.61 |
Where South Dakota sits
The same service costs 3.5 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
$95.50
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.