How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $123.03 Median $562.34 Typical High $4,365.16 | Facility | None | $123.03 | $562.34 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $131.83 Typical High $562.34 | Professional | None | $117.49 | $131.83 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $338.84 Typical High $1,548.82 | Professional | None | $239.88 | $338.84 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $741.31 Typical High $954.99 | Facility | None | $169.82 | $741.31 | $954.99 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $1,174.90 Typical High $3,981.07 | Professional | None | $478.63 | $1,174.90 | $3,981.07 |
Midlands Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $1,174.90 | Professional | None | $288.40 | $302.00 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $263.03 Typical High $1,122.02 | Professional | None | $239.88 | $263.03 | $1,122.02 |
Sanford Health Plan Setting Professional Modifier None Typical Low $173.78 Median $630.96 Typical High $977.24 | Professional | None | $173.78 | $630.96 | $977.24 |
United Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
United Setting Professional Modifier None Typical Low $162.18 Median $354.81 Typical High $1,548.82 | Professional | None | $162.18 | $354.81 | $1,548.82 |
Wellmark Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $1,380.38 | Professional | None | $223.87 | $275.42 | $1,380.38 |
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 $58.88 Median $66.07 Typical High $281.84 | Professional | 52 · Reduced service | $58.88 | $66.07 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $26.30 Typical High $112.20 | Professional | 53 · Discontinued | $23.44 | $26.30 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $97.72 Typical High $416.87 | Professional | 54 · Surgery only | $89.13 | $97.72 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $19.50 Typical High $85.11 | Professional | 55 · Aftercare only | $17.78 | $19.50 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $13.18 Typical High $56.23 | Professional | 56 · Pre-op care only | $11.75 | $13.18 | $56.23 |
Where South Dakota sits
The same service costs 4.0 times more in Wisconsin than in Maryland. 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· 9th of 51
$603
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.