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 $51.29 Median $2,290.87 Typical High $4,365.16 | Facility | None | $51.29 | $2,290.87 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $54.95 | Professional | None | $50.12 | $50.12 | $54.95 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $239.88 Typical High $323.59 | Facility | None | $70.79 | $239.88 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $114.82 Typical High $141.25 | Professional | None | $81.28 | $114.82 | $141.25 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $125.89 Typical High $223.87 | Facility | None | $72.44 | $125.89 | $223.87 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $120.23 Typical High $478.63 | Professional | None | $58.88 | $120.23 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $120.23 Typical High $120.23 | Professional | None | $104.71 | $120.23 | $120.23 |
Midlands Setting Facility Modifier None Typical Low $239.88 Median $316.23 Typical High $389.05 | Facility | None | $239.88 | $316.23 | $389.05 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $107.15 | Professional | None | $107.15 | $107.15 | $107.15 |
Sanford Health Plan Setting Professional Modifier None Typical Low $63.10 Median $79.43 Typical High $114.82 | Professional | None | $63.10 | $79.43 | $114.82 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $51.29 Median $97.72 Typical High $144.54 | Professional | None | $51.29 | $97.72 | $144.54 |
Wellmark Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $107.15 | Professional | None | $87.10 | $107.15 | $107.15 |
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 $25.12 Median $25.12 Typical High $27.54 | Professional | 52 · Reduced service | $25.12 | $25.12 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.00 Median $10.00 Typical High $10.96 | Professional | 53 · Discontinued | $10.00 | $10.00 | $10.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $38.02 Typical High $41.69 | Professional | 54 · Surgery only | $38.02 | $38.02 | $41.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $7.59 Typical High $8.32 | Professional | 55 · Aftercare only | $7.59 | $7.59 | $8.32 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.01 Median $5.01 Typical High $5.50 | Professional | 56 · Pre-op care only | $5.01 | $5.01 | $5.50 |
Where South Dakota sits
The same service costs 4.2 times more in Alaska 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· 5th of 51
$107
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.