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 $169.82 Median $288.40 Typical High $4,365.16 | Facility | None | $169.82 | $288.40 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $257.04 Typical High $316.23 | Professional | None | $144.54 | $257.04 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $190.55 Typical High $575.44 | Facility | None | $87.10 | $190.55 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $501.19 Typical High $741.31 | Professional | None | $331.13 | $501.19 | $741.31 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $245.47 Typical High $436.52 | Facility | None | $125.89 | $245.47 | $436.52 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $660.69 Typical High $2,238.72 | Professional | None | $251.19 | $660.69 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $660.69 | Professional | None | $389.05 | $389.05 | $660.69 |
Midlands Setting Facility Modifier None Typical Low $87.10 Median $186.21 Typical High $245.47 | Facility | None | $87.10 | $186.21 | $245.47 |
Midlands Setting Professional Modifier None Typical Low $309.03 Median $323.59 Typical High $501.19 | Professional | None | $309.03 | $323.59 | $501.19 |
Sanford Health Plan Setting Professional Modifier None Typical Low $251.19 Median $354.81 Typical High $575.44 | Professional | None | $251.19 | $354.81 | $575.44 |
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 $173.78 Median $446.68 Typical High $794.33 | Professional | None | $173.78 | $446.68 | $794.33 |
Wellmark Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $870.96 | Professional | None | $354.81 | $416.87 | $870.96 |
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 $72.44 Median $128.82 Typical High $158.49 | Professional | 52 · Reduced service | $72.44 | $128.82 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $51.29 Typical High $63.10 | Professional | 53 · Discontinued | $28.84 | $51.29 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $194.98 Typical High $234.42 | Professional | 54 · Surgery only | $109.65 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $38.90 Typical High $46.77 | Professional | 55 · Aftercare only | $21.88 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $25.70 Typical High $31.62 | Professional | 56 · Pre-op care only | $14.45 | $25.70 | $31.62 |
Where South Dakota sits
The same service costs 4.0 times more in Alaska than in Maryland. 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
$417
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.