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 $91.20 Median $128.82 Typical High $4,365.16 | Facility | None | $91.20 | $128.82 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $138.04 | Professional | None | $75.86 | $95.50 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $186.21 Median $380.19 Typical High $467.74 | Facility | None | $186.21 | $380.19 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $257.04 Typical High $371.54 | Professional | None | $199.53 | $257.04 | $371.54 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $186.21 Typical High $549.54 | Facility | None | $128.82 | $186.21 | $549.54 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $338.84 Typical High $954.99 | Professional | None | $138.04 | $338.84 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $295.12 | Professional | None | $218.78 | $218.78 | $295.12 |
Midlands Setting Facility Modifier None Typical Low $380.19 Median $446.68 Typical High $549.54 | Facility | None | $380.19 | $446.68 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $263.03 | Professional | None | $190.55 | $190.55 | $263.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $245.47 | Professional | None | $123.03 | $177.83 | $245.47 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $109.65 Median $251.19 Typical High $354.81 | Professional | None | $109.65 | $251.19 | $354.81 |
Wellmark Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $331.13 | Professional | None | $165.96 | $199.53 | $331.13 |
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 $38.02 Median $47.86 Typical High $69.18 | Professional | 52 · Reduced service | $38.02 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $19.50 Typical High $27.54 | Professional | 53 · Discontinued | $15.14 | $19.50 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $72.44 Typical High $104.71 | Professional | 54 · Surgery only | $57.54 | $72.44 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $14.45 Typical High $20.89 | Professional | 55 · Aftercare only | $11.48 | $14.45 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.55 Typical High $13.80 | Professional | 56 · Pre-op care only | $7.59 | $9.55 | $13.80 |
Where South Dakota sits
The same service costs 3.5 times more in Alaska than in Indiana. 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· 8th of 51
$219
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.