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 $102.33 Median $2,290.87 Typical High $4,365.16 | Facility | None | $102.33 | $2,290.87 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $107.15 | Professional | None | $97.72 | $97.72 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $173.78 | Facility | None | $138.04 | $138.04 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $275.42 | Professional | None | $158.49 | $223.87 | $275.42 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $223.87 | Facility | None | $125.89 | $151.36 | $223.87 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $245.47 Typical High $724.44 | Professional | None | $123.03 | $245.47 | $724.44 |
Midlands Setting Professional Modifier None Typical Low $204.17 Median $245.47 Typical High $245.47 | Professional | None | $204.17 | $245.47 | $245.47 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
Sanford Health Plan Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $186.21 | Professional | None | $123.03 | $158.49 | $186.21 |
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 $112.20 Median $190.55 Typical High $288.40 | Professional | None | $112.20 | $190.55 | $288.40 |
Wellmark Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $208.93 | Professional | None | $169.82 | $208.93 | $208.93 |
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 $48.98 Median $48.98 Typical High $53.70 | Professional | 52 · Reduced service | $48.98 | $48.98 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $21.38 | Professional | 53 · Discontinued | $19.50 | $19.50 | $21.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $72.44 Typical High $81.28 | Professional | 54 · Surgery only | $72.44 | $72.44 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $16.22 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $10.72 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $10.72 |
Where South Dakota sits
The same service costs 4.0 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
$209
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.