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 $158.49 Median $302.00 Typical High $4,365.16 | Facility | None | $158.49 | $302.00 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $169.82 Typical High $338.84 | Professional | None | $134.90 | $169.82 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $912.01 Typical High $1,258.93 | Facility | None | $457.09 | $912.01 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $912.01 | Professional | None | $371.54 | $457.09 | $912.01 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $457.09 Typical High $1,202.26 | Facility | None | $229.09 | $457.09 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $794.33 Typical High $2,290.87 | Professional | None | $295.12 | $794.33 | $2,290.87 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $676.08 | Professional | None | $371.54 | $371.54 | $676.08 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $954.99 Typical High $1,258.93 | Facility | None | $645.65 | $954.99 | $1,258.93 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $616.60 | Professional | None | $331.13 | $331.13 | $616.60 |
Sanford Health Plan Setting Professional Modifier None Typical Low $257.04 Median $363.08 Typical High $602.56 | Professional | None | $257.04 | $363.08 | $602.56 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $190.55 Median $436.52 Typical High $831.76 | Professional | None | $190.55 | $436.52 | $831.76 |
Wellmark Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $758.58 | Professional | None | $275.42 | $338.84 | $758.58 |
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 $67.61 Median $85.11 Typical High $169.82 | Professional | 52 · Reduced service | $67.61 | $85.11 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $33.88 Typical High $67.61 | Professional | 53 · Discontinued | $26.92 | $33.88 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $128.82 Typical High $257.04 | Professional | 54 · Surgery only | $100.00 | $128.82 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $25.70 Typical High $51.29 | Professional | 55 · Aftercare only | $20.42 | $25.70 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.98 Typical High $33.88 | Professional | 56 · Pre-op care only | $13.49 | $16.98 | $33.88 |
Where South Dakota sits
The same service costs 3.9 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· 10th of 51
$457
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.