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 $162.18 Median $2,951.21 Typical High $6,918.31 | Facility | None | $162.18 | $2,951.21 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $478.63 Typical High $2,951.21 | Professional | None | $141.25 | $478.63 | $2,951.21 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $4,570.88 Typical High $5,623.41 | Facility | None | $3,630.78 | $4,570.88 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $4,073.80 Typical High $7,244.36 | Professional | None | $363.08 | $4,073.80 | $7,244.36 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $2,818.38 Typical High $3,715.35 | Facility | None | $239.88 | $2,818.38 | $3,715.35 |
Medica Setting Professional Modifier None Typical Low $1,258.93 Median $6,309.57 Typical High $9,120.11 | Professional | None | $1,258.93 | $6,309.57 | $9,120.11 |
Midlands Setting Professional Modifier None Typical Low $363.08 Median $380.19 Typical High $6,309.57 | Professional | None | $363.08 | $380.19 | $6,309.57 |
Midlands Setting Facility Modifier None Typical Low $5,495.41 Median $5,623.41 Typical High $6,760.83 | Facility | None | $5,495.41 | $5,623.41 | $6,760.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $245.47 Median $2,454.71 Typical High $4,570.88 | Professional | None | $245.47 | $2,454.71 | $4,570.88 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,311.31 | Facility | None | $2,818.38 | $2,818.38 | $3,311.31 |
United Setting Professional Modifier None Typical Low $204.17 Median $478.63 Typical High $8,912.51 | Professional | None | $204.17 | $478.63 | $8,912.51 |
Wellmark Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $5,888.44 | Professional | None | $288.40 | $354.81 | $5,888.44 |
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 $70.79 Median $91.20 Typical High $1,348.96 | Professional | 52 · Reduced service | $70.79 | $91.20 | $1,348.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $36.31 Typical High $537.03 | Professional | 53 · Discontinued | $28.84 | $36.31 | $537.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $134.90 Typical High $2,041.74 | Professional | 54 · Surgery only | $107.15 | $134.90 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $26.92 Typical High $407.38 | Professional | 55 · Aftercare only | $21.38 | $26.92 | $407.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $18.20 Typical High $269.15 | Professional | 56 · Pre-op care only | $14.13 | $18.20 | $269.15 |
Where South Dakota sits
The same service costs 33.1 times more in Alaska 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· 14th of 51
$2,951
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.