How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $151.36 Median $1,698.24 Typical High $4,365.16 | Facility | None | $151.36 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $457.09 Typical High $1,905.46 | Professional | None | $141.25 | $457.09 | $1,905.46 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,949.84 Typical High $2,454.71 | Facility | None | $1,202.26 | $1,949.84 | $2,454.71 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $3,890.45 | Professional | None | $323.59 | $416.87 | $3,890.45 |
Medica Setting Facility Modifier None Typical Low $239.88 Median $891.25 Typical High $2,344.23 | Facility | None | $239.88 | $891.25 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $3,548.13 Typical High $4,786.30 | Professional | None | $1,445.44 | $3,548.13 | $4,786.30 |
Midlands Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $3,630.78 | Professional | None | $338.84 | $338.84 | $3,630.78 |
Midlands Setting Facility Modifier None Typical Low $1,202.26 Median $1,348.96 Typical High $1,819.70 | Facility | None | $1,202.26 | $1,348.96 | $1,819.70 |
Sanford Health Plan Setting Professional Modifier None Typical Low $213.80 Median $1,318.26 Typical High $2,511.89 | Professional | None | $213.80 | $1,318.26 | $2,511.89 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $173.78 Median $416.87 Typical High $4,786.30 | Professional | None | $173.78 | $416.87 | $4,786.30 |
Wellmark Setting Professional Modifier None Typical Low $275.42 Median $338.84 Typical High $3,388.44 | Professional | None | $275.42 | $338.84 | $3,388.44 |
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 $70.79 Median $79.43 Typical High $758.58 | Professional | 52 · Reduced service | $70.79 | $79.43 | $758.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $31.62 Typical High $302.00 | Professional | 53 · Discontinued | $28.84 | $31.62 | $302.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $117.49 Typical High $1,122.02 | Professional | 54 · Surgery only | $107.15 | $117.49 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $23.44 Typical High $223.87 | Professional | 55 · Aftercare only | $21.38 | $23.44 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $15.85 Typical High $151.36 | Professional | 56 · Pre-op care only | $14.13 | $15.85 | $151.36 |
Where South Dakota sits
The same service costs 8.5 times more in Wisconsin than in Nebraska. 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· 23rd of 51
$1,413
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.