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 $208.93 Median $1,096.48 Typical High $4,365.16 | Facility | None | $208.93 | $1,096.48 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $288.40 Typical High $1,258.93 | Professional | None | $204.17 | $288.40 | $1,258.93 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $3,019.95 | Professional | None | $446.68 | $588.84 | $3,019.95 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $812.83 Typical High $1,778.28 | Facility | None | $295.12 | $812.83 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $933.25 Median $2,398.83 Typical High $7,585.78 | Professional | None | $933.25 | $2,398.83 | $7,585.78 |
Midlands Setting Professional Modifier None Typical Low $489.78 Median $524.81 Typical High $2,344.23 | Professional | None | $489.78 | $524.81 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $2,238.72 | Professional | None | $416.87 | $446.68 | $2,238.72 |
Sanford Health Plan Setting Professional Modifier None Typical Low $302.00 Median $1,258.93 Typical High $1,905.46 | Professional | None | $302.00 | $1,258.93 | $1,905.46 |
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 $281.84 Median $660.69 Typical High $3,090.30 | Professional | None | $281.84 | $660.69 | $3,090.30 |
Wellmark Setting Professional Modifier None Typical Low $389.05 Median $478.63 Typical High $2,691.53 | Professional | None | $389.05 | $478.63 | $2,691.53 |
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 $102.33 Median $114.82 Typical High $549.54 | Professional | 52 · Reduced service | $102.33 | $114.82 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $45.71 Typical High $218.78 | Professional | 53 · Discontinued | $40.74 | $45.71 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $169.82 Typical High $831.76 | Professional | 54 · Surgery only | $151.36 | $169.82 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $33.88 Typical High $165.96 | Professional | 55 · Aftercare only | $30.90 | $33.88 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $22.91 Typical High $109.65 | Professional | 56 · Pre-op care only | $20.42 | $22.91 | $109.65 |
Where South Dakota sits
The same service costs 4.1 times more in Washington 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· 6th of 51
$1,230
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.