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 $257.04 Median $1,412.54 Typical High $4,365.16 | Facility | None | $257.04 | $1,412.54 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $281.84 Typical High $1,412.54 | Professional | None | $239.88 | $281.84 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $891.25 Typical High $3,630.78 | Professional | None | $537.03 | $891.25 | $3,630.78 |
Medica Setting Facility Modifier None Typical Low $346.74 Median $1,737.80 Typical High $3,162.28 | Facility | None | $346.74 | $1,737.80 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $1,230.27 Median $3,090.30 Typical High $4,786.30 | Professional | None | $1,230.27 | $3,090.30 | $4,786.30 |
Midlands Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $3,090.30 | Professional | None | $602.56 | $616.60 | $3,090.30 |
Midlands Setting Professional Modifier None Typical Low $478.63 Median $537.03 Typical High $2,884.03 | Professional | None | $478.63 | $537.03 | $2,884.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $363.08 Median $1,698.24 Typical High $2,344.23 | Professional | None | $363.08 | $1,698.24 | $2,344.23 |
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 $338.84 Median $741.31 Typical High $3,981.07 | Professional | None | $338.84 | $741.31 | $3,981.07 |
Wellmark Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $3,162.28 | Professional | None | $467.74 | $575.44 | $3,162.28 |
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 $120.23 Median $131.83 Typical High $707.95 | Professional | 52 · Reduced service | $120.23 | $131.83 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $53.70 Typical High $281.84 | Professional | 53 · Discontinued | $47.86 | $53.70 | $281.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $199.53 Typical High $1,071.52 | Professional | 54 · Surgery only | $181.97 | $199.53 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $39.81 Typical High $213.80 | Professional | 55 · Aftercare only | $36.31 | $39.81 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $26.92 Typical High $141.25 | Professional | 56 · Pre-op care only | $23.99 | $26.92 | $141.25 |
Where South Dakota sits
The same service costs 4.7 times more in Wisconsin than in Nebraska. 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· 5th of 51
$1,660
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.