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 $194.98 Median $1,071.52 Typical High $4,365.16 | Facility | None | $194.98 | $1,071.52 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $263.03 Typical High $1,174.90 | Professional | None | $186.21 | $263.03 | $1,174.90 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $691.83 Typical High $2,818.38 | Professional | None | $426.58 | $691.83 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $1,348.96 Typical High $2,754.23 | Facility | None | $269.15 | $1,348.96 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $2,344.23 Typical High $3,630.78 | Professional | None | $912.01 | $2,344.23 | $3,630.78 |
Midlands Setting Professional Modifier None Typical Low $446.68 Median $478.63 Typical High $2,344.23 | Professional | None | $446.68 | $478.63 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $426.58 Typical High $2,137.96 | Professional | None | $371.54 | $426.58 | $2,137.96 |
Sanford Health Plan Setting Professional Modifier None Typical Low $281.84 Median $1,258.93 Typical High $1,819.70 | Professional | None | $281.84 | $1,258.93 | $1,819.70 |
United Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
United Setting Professional Modifier None Typical Low $269.15 Median $549.54 Typical High $2,951.21 | Professional | None | $269.15 | $549.54 | $2,951.21 |
Wellmark Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $2,454.71 | Professional | None | $371.54 | $457.09 | $2,454.71 |
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 $93.33 Median $102.33 Typical High $537.03 | Professional | 52 · Reduced service | $93.33 | $102.33 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $37.15 Median $40.74 Typical High $213.80 | Professional | 53 · Discontinued | $37.15 | $40.74 | $213.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $154.88 Typical High $794.33 | Professional | 54 · Surgery only | $138.04 | $154.88 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $30.90 Typical High $162.18 | Professional | 55 · Aftercare only | $27.54 | $30.90 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $20.42 Typical High $107.15 | Professional | 56 · Pre-op care only | $18.62 | $20.42 | $107.15 |
Where South Dakota sits
The same service costs 5.9 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· 7th 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.