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 $173.78 Median $2,290.87 Typical High $4,365.16 | Facility | None | $173.78 | $2,290.87 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $190.55 | Professional | None | $169.82 | $169.82 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $239.88 Median $295.12 Typical High $323.59 | Facility | None | $239.88 | $295.12 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $389.05 Typical High $489.78 | Professional | None | $275.42 | $389.05 | $489.78 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $223.87 Typical High $316.23 | Facility | None | $125.89 | $223.87 | $316.23 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $407.38 Typical High $1,698.24 | Professional | None | $154.88 | $407.38 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $338.84 Median $407.38 Typical High $407.38 | Professional | None | $338.84 | $407.38 | $407.38 |
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 $229.09 Median $229.09 Typical High $229.09 | Professional | None | $229.09 | $229.09 | $229.09 |
Sanford Health Plan Setting Professional Modifier None Typical Low $147.91 Median $234.42 Typical High $323.59 | Professional | None | $147.91 | $234.42 | $323.59 |
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 $151.36 Median $331.13 Typical High $478.63 | Professional | None | $151.36 | $331.13 | $478.63 |
Wellmark Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $371.54 | Professional | None | $302.00 | $371.54 | $371.54 |
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 $85.11 Median $85.11 Typical High $93.33 | Professional | 52 · Reduced service | $85.11 | $85.11 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $33.88 Typical High $38.02 | Professional | 53 · Discontinued | $33.88 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $128.82 Typical High $141.25 | Professional | 54 · Surgery only | $128.82 | $128.82 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $25.70 Typical High $28.18 | Professional | 55 · Aftercare only | $25.70 | $25.70 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $16.98 Typical High $19.05 | Professional | 56 · Pre-op care only | $16.98 | $16.98 | $19.05 |
Where South Dakota sits
The same service costs 4.6 times more in Alaska than in Utah. 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
$355
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.