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 $52.48 Median $204.17 Typical High $4,365.16 | Facility | None | $52.48 | $204.17 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $104.71 Typical High $208.93 | Professional | None | $42.66 | $104.71 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $389.05 | Facility | None | $309.03 | $309.03 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $257.04 Typical High $575.44 | Professional | None | $104.71 | $257.04 | $575.44 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $151.36 Typical High $309.03 | Facility | None | $70.79 | $151.36 | $309.03 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $416.87 Typical High $2,238.72 | Professional | None | $165.96 | $416.87 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $416.87 | Professional | None | $123.03 | $123.03 | $416.87 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $117.49 Typical High $371.54 | Professional | None | $104.71 | $117.49 | $371.54 |
Sanford Health Plan Setting Professional Modifier None Typical Low $66.07 Median $199.53 Typical High $380.19 | Professional | None | $66.07 | $199.53 | $380.19 |
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 $61.66 Median $165.96 Typical High $575.44 | Professional | None | $61.66 | $165.96 | $575.44 |
Wellmark Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $524.81 | Professional | None | $95.50 | $112.20 | $524.81 |
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 $21.38 Median $52.48 Typical High $104.71 | Professional | 52 · Reduced service | $21.38 | $52.48 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $21.38 Typical High $42.66 | Professional | 53 · Discontinued | $8.51 | $21.38 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $79.43 Typical High $158.49 | Professional | 54 · Surgery only | $31.62 | $79.43 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $15.85 Typical High $31.62 | Professional | 55 · Aftercare only | $6.31 | $15.85 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $10.47 Typical High $20.89 | Professional | 56 · Pre-op care only | $4.27 | $10.47 | $20.89 |
Where South Dakota sits
The same service costs 4.6 times more in Iowa than in Kentucky. 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· 13th of 51
$204
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.