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 $309.03 Median $1,548.82 Typical High $4,365.16 | Facility | None | $309.03 | $1,548.82 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $436.52 Typical High $1,819.70 | Professional | None | $302.00 | $436.52 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $1,071.52 Typical High $4,677.35 | Professional | None | $660.69 | $1,071.52 | $4,677.35 |
Medica Setting Facility Modifier None Typical Low $436.52 Median $1,819.70 Typical High $3,715.35 | Facility | None | $436.52 | $1,819.70 | $3,715.35 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $3,311.31 Typical High $6,025.60 | Professional | None | $1,348.96 | $3,311.31 | $6,025.60 |
Midlands Setting Professional Modifier None Typical Low $707.95 Median $776.25 Typical High $3,311.31 | Professional | None | $707.95 | $776.25 | $3,311.31 |
Midlands Setting Professional Modifier None Typical Low $602.56 Median $660.69 Typical High $3,162.28 | Professional | None | $602.56 | $660.69 | $3,162.28 |
Sanford Health Plan Setting Professional Modifier None Typical Low $467.74 Median $1,819.70 Typical High $2,884.03 | Professional | None | $467.74 | $1,819.70 | $2,884.03 |
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 $416.87 Median $851.14 Typical High $4,365.16 | Professional | None | $416.87 | $851.14 | $4,365.16 |
Wellmark Setting Professional Modifier None Typical Low $616.60 Median $758.58 Typical High $4,570.88 | Professional | None | $616.60 | $758.58 | $4,570.88 |
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 $151.36 Median $169.82 Typical High $812.83 | Professional | 52 · Reduced service | $151.36 | $169.82 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $60.26 Median $67.61 Typical High $323.59 | Professional | 53 · Discontinued | $60.26 | $67.61 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $251.19 Typical High $1,202.26 | Professional | 54 · Surgery only | $229.09 | $251.19 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $50.12 Typical High $239.88 | Professional | 55 · Aftercare only | $45.71 | $50.12 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $33.88 Typical High $162.18 | Professional | 56 · Pre-op care only | $30.20 | $33.88 | $162.18 |
Where South Dakota sits
The same service costs 5.6 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
$1,820
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.