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 $186.21 Median $309.03 Typical High $4,365.16 | Facility | None | $186.21 | $309.03 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $275.42 Typical High $338.84 | Professional | None | $158.49 | $275.42 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $190.55 Typical High $616.60 | Facility | None | $173.78 | $190.55 | $616.60 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $549.54 Typical High $794.33 | Professional | None | $363.08 | $549.54 | $794.33 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $263.03 Typical High $467.74 | Facility | None | $125.89 | $263.03 | $467.74 |
Medica Setting Professional Modifier None Typical Low $269.15 Median $707.95 Typical High $2,398.83 | Professional | None | $269.15 | $707.95 | $2,398.83 |
Midlands Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $707.95 | Professional | None | $426.58 | $426.58 | $707.95 |
Midlands Setting Facility Modifier None Typical Low $173.78 Median $186.21 Typical High $245.47 | Facility | None | $173.78 | $186.21 | $245.47 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $371.54 Typical High $588.84 | Professional | None | $331.13 | $371.54 | $588.84 |
Sanford Health Plan Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $616.60 | Professional | None | $275.42 | $389.05 | $616.60 |
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 $204.17 Median $489.78 Typical High $851.14 | Professional | None | $204.17 | $489.78 | $851.14 |
Wellmark Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $933.25 | Professional | None | $389.05 | $457.09 | $933.25 |
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 $79.43 Median $138.04 Typical High $169.82 | Professional | 52 · Reduced service | $79.43 | $138.04 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $54.95 Typical High $67.61 | Professional | 53 · Discontinued | $31.62 | $54.95 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $208.93 Typical High $251.19 | Professional | 54 · Surgery only | $117.49 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $41.69 Typical High $50.12 | Professional | 55 · Aftercare only | $23.44 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $27.54 Typical High $33.88 | Professional | 56 · Pre-op care only | $15.85 | $27.54 | $33.88 |
Where South Dakota sits
The same service costs 3.8 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· 7th of 51
$447
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.