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 $245.47 Median $870.96 Typical High $4,365.16 | Facility | None | $245.47 | $870.96 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $1,288.25 | Professional | None | $234.42 | $363.08 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $660.69 Typical High $2,344.23 | Professional | None | $524.81 | $660.69 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $812.83 Typical High $1,659.59 | Facility | None | $338.84 | $812.83 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,905.46 Typical High $7,244.36 | Professional | None | $758.58 | $1,905.46 | $7,244.36 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $616.60 Typical High $1,905.46 | Professional | None | $575.44 | $616.60 | $1,905.46 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $524.81 Typical High $1,778.28 | Professional | None | $467.74 | $524.81 | $1,778.28 |
Sanford Health Plan Setting Professional Modifier None Typical Low $354.81 Median $1,023.29 Typical High $1,548.82 | Professional | None | $354.81 | $1,023.29 | $1,548.82 |
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 $338.84 Median $707.95 Typical High $2,398.83 | Professional | None | $338.84 | $707.95 | $2,398.83 |
Wellmark Setting Professional Modifier None Typical Low $457.09 Median $562.34 Typical High $2,041.74 | Professional | None | $457.09 | $562.34 | $2,041.74 |
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 $117.49 Median $128.82 Typical High $436.52 | Professional | 52 · Reduced service | $117.49 | $128.82 | $436.52 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $52.48 Typical High $173.78 | Professional | 53 · Discontinued | $46.77 | $52.48 | $173.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $194.98 Typical High $645.65 | Professional | 54 · Surgery only | $177.83 | $194.98 | $645.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $38.90 Typical High $128.82 | Professional | 55 · Aftercare only | $35.48 | $38.90 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $26.30 Typical High $87.10 | Professional | 56 · Pre-op care only | $23.44 | $26.30 | $87.10 |
Where South Dakota sits
The same service costs 4.3 times more in Wisconsin than in Hawaii. 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· 9th of 51
$977
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.