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 $123.03 Median $2,290.87 Typical High $4,365.16 | Facility | None | $123.03 | $2,290.87 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $128.82 | Professional | None | $117.49 | $117.49 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $239.88 Typical High $323.59 | Facility | None | $165.96 | $239.88 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $269.15 Typical High $331.13 | Professional | None | $186.21 | $269.15 | $331.13 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $194.98 Typical High $316.23 | Facility | None | $125.89 | $194.98 | $316.23 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $281.84 Typical High $1,737.80 | Professional | None | $134.90 | $281.84 | $1,737.80 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $281.84 Typical High $281.84 | Professional | None | $275.42 | $281.84 | $281.84 |
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 $239.88 Median $239.88 Typical High $239.88 | Professional | None | $239.88 | $239.88 | $239.88 |
Sanford Health Plan Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $239.88 | Professional | None | $147.91 | $199.53 | $239.88 |
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 $125.89 Median $245.47 Typical High $338.84 | Professional | None | $125.89 | $245.47 | $338.84 |
Wellmark Setting Professional Modifier None Typical Low $239.88 Median $288.40 Typical High $288.40 | Professional | None | $239.88 | $288.40 | $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 $57.54 Median $57.54 Typical High $64.57 | Professional | 52 · Reduced service | $57.54 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $25.70 | Professional | 53 · Discontinued | $23.44 | $23.44 | $25.70 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | 54 · Surgery only | $87.10 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $19.05 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $11.75 Typical High $12.88 | Professional | 56 · Pre-op care only | $11.75 | $11.75 | $12.88 |
Where South Dakota sits
The same service costs 5.1 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· 6th of 51
$251
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.