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 $9.12 Median $9.12 Typical High $28.18 | Facility | None | $9.12 | $9.12 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $8.91 Median $23.44 Typical High $36.31 | Professional | None | $8.91 | $23.44 | $36.31 |
Cigna Setting Facility Modifier None Typical Low $46.77 Median $46.77 Typical High $58.88 | Facility | None | $46.77 | $46.77 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $61.66 Typical High $93.33 | Professional | None | $20.89 | $61.66 | $93.33 |
Medica Setting Facility Modifier None Typical Low $15.14 Median $53.70 Typical High $151.36 | Facility | None | $15.14 | $53.70 | $151.36 |
Medica Setting Professional Modifier None Typical Low $26.92 Median $75.86 Typical High $338.84 | Professional | None | $26.92 | $75.86 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $61.66 | Professional | None | $21.88 | $21.88 | $61.66 |
Sanford Health Plan Setting Professional Modifier None Typical Low $14.45 Median $30.20 Typical High $57.54 | Professional | None | $14.45 | $30.20 | $57.54 |
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 $11.22 Median $25.70 Typical High $79.43 | Professional | None | $11.22 | $25.70 | $79.43 |
Wellmark Setting Professional Modifier None Typical Low $16.60 Median $20.42 Typical High $79.43 | Professional | None | $16.60 | $20.42 | $79.43 |
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 $4.47 Median $5.01 Typical High $18.20 | Professional | 52 · Reduced service | $4.47 | $5.01 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.82 Median $2.00 Typical High $7.24 | Professional | 53 · Discontinued | $1.82 | $2.00 | $7.24 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $6.76 Median $7.59 Typical High $26.92 | Professional | 54 · Surgery only | $6.76 | $7.59 | $26.92 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.35 Median $1.51 Typical High $5.50 | Professional | 55 · Aftercare only | $1.35 | $1.51 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.89 Median $1.00 Typical High $3.63 | Professional | 56 · Pre-op care only | $0.89 | $1.00 | $3.63 |
Where South Dakota sits
The same service costs 4.2 times more in Wisconsin than in Nebraska. 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· 17th of 51
$33.11
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.