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 $269.15 Median $1,148.15 Typical High $4,365.16 | Facility | None | $269.15 | $1,148.15 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $1,318.26 | Professional | None | $257.04 | $295.12 | $1,318.26 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $933.25 Typical High $3,019.95 | Professional | None | $549.54 | $933.25 | $3,019.95 |
Medica Setting Facility Modifier None Typical Low $363.08 Median $812.83 Typical High $1,819.70 | Facility | None | $363.08 | $812.83 | $1,819.70 |
Medica Setting Professional Modifier None Typical Low $1,000.00 Median $2,511.89 Typical High $7,762.47 | Professional | None | $1,000.00 | $2,511.89 | $7,762.47 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $660.69 Typical High $2,511.89 | Professional | None | $616.60 | $660.69 | $2,511.89 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $575.44 Typical High $2,344.23 | Professional | None | $512.86 | $575.44 | $2,344.23 |
Sanford Health Plan Setting Professional Modifier None Typical Low $380.19 Median $1,380.38 Typical High $1,995.26 | Professional | None | $380.19 | $1,380.38 | $1,995.26 |
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 $363.08 Median $758.58 Typical High $3,235.94 | Professional | None | $363.08 | $758.58 | $3,235.94 |
Wellmark Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $2,754.23 | Professional | None | $512.86 | $616.60 | $2,754.23 |
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 $128.82 Median $141.25 Typical High $575.44 | Professional | 52 · Reduced service | $128.82 | $141.25 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $51.29 Median $56.23 Typical High $229.09 | Professional | 53 · Discontinued | $51.29 | $56.23 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $213.80 Typical High $870.96 | Professional | 54 · Surgery only | $190.55 | $213.80 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $42.66 Typical High $173.78 | Professional | 55 · Aftercare only | $38.02 | $42.66 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.70 Median $28.18 Typical High $114.82 | Professional | 56 · Pre-op care only | $25.70 | $28.18 | $114.82 |
Where South Dakota sits
The same service costs 3.5 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· 6th of 51
$1,349
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.