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 $354.81 Median $2,238.72 Typical High $4,365.16 | Facility | None | $354.81 | $2,238.72 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $2,238.72 | Professional | None | $338.84 | $398.11 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $977.24 Typical High $5,754.40 | Professional | None | $741.31 | $977.24 | $5,754.40 |
Medica Setting Facility Modifier None Typical Low $489.78 Median $2,691.53 Typical High $5,370.32 | Facility | None | $489.78 | $2,691.53 | $5,370.32 |
Medica Setting Professional Modifier None Typical Low $1,949.84 Median $5,011.87 Typical High $7,413.10 | Professional | None | $1,949.84 | $5,011.87 | $7,413.10 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $870.96 Typical High $5,011.87 | Professional | None | $851.14 | $870.96 | $5,011.87 |
Midlands Setting Professional Modifier None Typical Low $691.83 Median $741.31 Typical High $4,570.88 | Professional | None | $691.83 | $741.31 | $4,570.88 |
Sanford Health Plan Setting Professional Modifier None Typical Low $501.19 Median $2,691.53 Typical High $3,715.35 | Professional | None | $501.19 | $2,691.53 | $3,715.35 |
United Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $5,370.32 | Facility | None | $5,370.32 | $5,370.32 | $5,370.32 |
United Setting Professional Modifier None Typical Low $467.74 Median $1,023.29 Typical High $6,309.57 | Professional | None | $467.74 | $1,023.29 | $6,309.57 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $776.25 Typical High $4,897.79 | Professional | None | $630.96 | $776.25 | $4,897.79 |
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 $169.82 Median $190.55 Typical High $1,122.02 | Professional | 52 · Reduced service | $169.82 | $190.55 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $75.86 Typical High $446.68 | Professional | 53 · Discontinued | $67.61 | $75.86 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $288.40 Typical High $1,698.24 | Professional | 54 · Surgery only | $257.04 | $288.40 | $1,698.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $57.54 Typical High $338.84 | Professional | 55 · Aftercare only | $51.29 | $57.54 | $338.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $38.02 Typical High $223.87 | Professional | 56 · Pre-op care only | $33.88 | $38.02 | $223.87 |
Where South Dakota sits
The same service costs 6.9 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· 8th of 51
$2,455
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.