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 $117.49 Median $269.15 Typical High $4,365.16 | Facility | None | $117.49 | $269.15 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $234.42 Typical High $323.59 | Professional | None | $100.00 | $234.42 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $954.99 Typical High $1,258.93 | Facility | None | $398.11 | $954.99 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $794.33 | Professional | None | $269.15 | $346.74 | $794.33 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $398.11 Typical High $1,202.26 | Facility | None | $169.82 | $398.11 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $724.44 Typical High $1,995.26 | Professional | None | $234.42 | $724.44 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $602.56 | Professional | None | $269.15 | $269.15 | $602.56 |
Midlands Setting Facility Modifier None Typical Low $912.01 Median $954.99 Typical High $1,258.93 | Facility | None | $912.01 | $954.99 | $1,258.93 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $549.54 | Professional | None | $245.47 | $245.47 | $549.54 |
Sanford Health Plan Setting Professional Modifier None Typical Low $194.98 Median $288.40 Typical High $489.78 | Professional | None | $194.98 | $288.40 | $489.78 |
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 $141.25 Median $323.59 Typical High $758.58 | Professional | None | $141.25 | $323.59 | $758.58 |
Wellmark Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $660.69 | Professional | None | $208.93 | $257.04 | $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 $50.12 Median $64.57 Typical High $147.91 | Professional | 52 · Reduced service | $50.12 | $64.57 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.70 Typical High $58.88 | Professional | 53 · Discontinued | $20.42 | $25.70 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $95.50 Typical High $223.87 | Professional | 54 · Surgery only | $75.86 | $95.50 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.05 Typical High $44.67 | Professional | 55 · Aftercare only | $15.14 | $19.05 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.88 Typical High $29.51 | Professional | 56 · Pre-op care only | $10.00 | $12.88 | $29.51 |
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· 15th 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.