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 $69.18 Median $97.72 Typical High $4,365.16 | Facility | None | $69.18 | $97.72 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $87.10 Typical High $104.71 | Professional | None | $58.88 | $87.10 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $95.50 Typical High $190.55 | Facility | None | $79.43 | $95.50 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $190.55 Typical High $245.47 | Professional | None | $134.90 | $190.55 | $245.47 |
Medica Setting Facility Modifier None Typical Low $95.50 Median $125.89 Typical High $223.87 | Facility | None | $95.50 | $125.89 | $223.87 |
Medica Setting Professional Modifier None Typical Low $85.11 Median $223.87 Typical High $758.58 | Professional | None | $85.11 | $223.87 | $758.58 |
Midlands Setting Professional Modifier None Typical Low $158.49 Median $158.49 Typical High $223.87 | Professional | None | $158.49 | $158.49 | $223.87 |
Midlands Setting Facility Modifier None Typical Low $79.43 Median $95.50 Typical High $125.89 | Facility | None | $79.43 | $95.50 | $125.89 |
Midlands Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $162.18 | Professional | None | $120.23 | $125.89 | $162.18 |
Sanford Health Plan Setting Professional Modifier None Typical Low $89.13 Median $128.82 Typical High $190.55 | Professional | None | $89.13 | $128.82 | $190.55 |
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 $66.07 Median $144.54 Typical High $269.15 | Professional | None | $66.07 | $144.54 | $269.15 |
Wellmark Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $288.40 | Professional | None | $144.54 | $169.82 | $288.40 |
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 $29.51 Median $43.65 Typical High $52.48 | Professional | 52 · Reduced service | $29.51 | $43.65 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $17.38 Typical High $20.89 | Professional | 53 · Discontinued | $11.75 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $64.57 Typical High $79.43 | Professional | 54 · Surgery only | $43.65 | $64.57 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $12.88 Typical High $15.85 | Professional | 55 · Aftercare only | $8.71 | $12.88 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $8.71 Typical High $10.47 | Professional | 56 · Pre-op care only | $5.89 | $8.71 | $10.47 |
Where South Dakota sits
The same service costs 3.8 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
$158
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.