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 $48.98 Median $138.04 Typical High $4,365.16 | Facility | None | $48.98 | $138.04 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $63.10 Typical High $169.82 | Professional | None | $46.77 | $63.10 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $134.90 Typical High $331.13 | Professional | None | $107.15 | $134.90 | $331.13 |
Medica Setting Facility Modifier None Typical Low $66.07 Median $154.88 Typical High $323.59 | Facility | None | $66.07 | $154.88 | $323.59 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $331.13 Typical High $1,047.13 | Professional | None | $120.23 | $331.13 | $1,047.13 |
Midlands Setting Professional Modifier None Typical Low $114.82 Median $120.23 Typical High $331.13 | Professional | None | $114.82 | $120.23 | $331.13 |
Midlands Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $281.84 | Professional | None | $93.33 | $102.33 | $281.84 |
Sanford Health Plan Setting Professional Modifier None Typical Low $69.18 Median $162.18 Typical High $245.47 | Professional | None | $69.18 | $162.18 | $245.47 |
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 $64.57 Median $134.90 Typical High $389.05 | Professional | None | $64.57 | $134.90 | $389.05 |
Wellmark Setting Professional Modifier None Typical Low $87.10 Median $104.71 Typical High $288.40 | Professional | None | $87.10 | $104.71 | $288.40 |
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 $22.91 Median $25.70 Typical High $64.57 | Professional | 52 · Reduced service | $22.91 | $25.70 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.47 Typical High $26.30 | Professional | 53 · Discontinued | $9.33 | $10.47 | $26.30 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $34.67 Median $38.90 Typical High $97.72 | Professional | 54 · Surgery only | $34.67 | $38.90 | $97.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $7.76 Typical High $19.50 | Professional | 55 · Aftercare only | $6.92 | $7.76 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.25 Typical High $12.88 | Professional | 56 · Pre-op care only | $4.68 | $5.25 | $12.88 |
Where South Dakota sits
The same service costs 2.8 times more in Wisconsin than in Florida. 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
$162
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.