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 $131.83 Median $263.03 Typical High $4,365.16 | Facility | None | $131.83 | $263.03 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $144.54 Typical High $281.84 | Professional | None | $114.82 | $144.54 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $302.00 Typical High $501.19 | Facility | None | $131.83 | $302.00 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $794.33 | Professional | None | $309.03 | $457.09 | $794.33 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $223.87 Typical High $416.87 | Facility | None | $125.89 | $223.87 | $416.87 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $707.95 Typical High $2,041.74 | Professional | None | $257.04 | $707.95 | $2,041.74 |
Midlands Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $588.84 | Professional | None | $309.03 | $309.03 | $588.84 |
Midlands Setting Facility Modifier None Typical Low $131.83 Median $302.00 Typical High $954.99 | Facility | None | $131.83 | $302.00 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $537.03 | Professional | None | $275.42 | $275.42 | $537.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $218.78 Median $323.59 Typical High $524.81 | Professional | None | $218.78 | $323.59 | $524.81 |
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 $158.49 Median $371.54 Typical High $741.31 | Professional | None | $158.49 | $371.54 | $741.31 |
Wellmark Setting Professional Modifier None Typical Low $234.42 Median $288.40 Typical High $660.69 | Professional | None | $234.42 | $288.40 | $660.69 |
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 $57.54 Median $72.44 Typical High $147.91 | Professional | 52 · Reduced service | $57.54 | $72.44 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $28.84 Typical High $60.26 | Professional | 53 · Discontinued | $22.91 | $28.84 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $109.65 Typical High $223.87 | Professional | 54 · Surgery only | $85.11 | $109.65 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $21.88 Typical High $44.67 | Professional | 55 · Aftercare only | $16.98 | $21.88 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.45 Typical High $30.20 | Professional | 56 · Pre-op care only | $11.48 | $14.45 | $30.20 |
Where South Dakota sits
The same service costs 3.2 times more in Wisconsin 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· 11th of 51
$355
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.