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 $275.42 Median $1,258.93 Typical High $4,365.16 | Facility | None | $275.42 | $1,258.93 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $380.19 Typical High $1,548.82 | Professional | None | $269.15 | $380.19 | $1,548.82 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $1,288.25 Typical High $3,388.44 | Professional | None | $602.56 | $1,288.25 | $3,388.44 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $1,659.59 Typical High $3,162.28 | Facility | None | $380.19 | $1,659.59 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $2,754.23 Typical High $4,677.35 | Professional | None | $1,096.48 | $2,754.23 | $4,677.35 |
Midlands Setting Professional Modifier None Typical Low $630.96 Median $691.83 Typical High $2,754.23 | Professional | None | $630.96 | $691.83 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $537.03 Median $588.84 Typical High $2,570.40 | Professional | None | $537.03 | $588.84 | $2,570.40 |
Sanford Health Plan Setting Professional Modifier None Typical Low $407.38 Median $1,513.56 Typical High $2,187.76 | Professional | None | $407.38 | $1,513.56 | $2,187.76 |
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 $371.54 Median $776.25 Typical High $3,548.13 | Professional | None | $371.54 | $776.25 | $3,548.13 |
Wellmark Setting Professional Modifier None Typical Low $524.81 Median $645.65 Typical High $3,235.94 | Professional | None | $524.81 | $645.65 | $3,235.94 |
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 $131.83 Median $147.91 Typical High $630.96 | Professional | 52 · Reduced service | $131.83 | $147.91 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $58.88 Typical High $251.19 | Professional | 53 · Discontinued | $53.70 | $58.88 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $218.78 Typical High $954.99 | Professional | 54 · Surgery only | $199.53 | $218.78 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $44.67 Typical High $190.55 | Professional | 55 · Aftercare only | $39.81 | $44.67 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $29.51 Typical High $125.89 | Professional | 56 · Pre-op care only | $26.92 | $29.51 | $125.89 |
Where South Dakota sits
The same service costs 5.1 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· 10th of 51
$1,514
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.