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 $87.10 Median $288.40 Typical High $4,365.16 | Facility | None | $87.10 | $288.40 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $93.33 Typical High $281.84 | Professional | None | $83.18 | $93.33 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $363.08 Typical High $446.68 | Facility | None | $363.08 | $363.08 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $245.47 Typical High $724.44 | Professional | None | $190.55 | $245.47 | $724.44 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $426.58 | Facility | None | $125.89 | $151.36 | $426.58 |
Medica Setting Professional Modifier None Typical Low $251.19 Median $575.44 Typical High $812.83 | Professional | None | $251.19 | $575.44 | $812.83 |
Midlands Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $616.60 | Professional | None | $199.53 | $199.53 | $616.60 |
Sanford Health Plan Setting Professional Modifier None Typical Low $125.89 Median $331.13 Typical High $478.63 | Professional | None | $125.89 | $331.13 | $478.63 |
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 $100.00 Median $239.88 Typical High $812.83 | Professional | None | $100.00 | $239.88 | $812.83 |
Wellmark Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $616.60 | Professional | None | $162.18 | $199.53 | $616.60 |
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 $41.69 Median $46.77 Typical High $141.25 | Professional | 52 · Reduced service | $41.69 | $46.77 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $18.62 Typical High $56.23 | Professional | 53 · Discontinued | $16.60 | $18.62 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $69.18 Typical High $208.93 | Professional | 54 · Surgery only | $63.10 | $69.18 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $14.13 Typical High $41.69 | Professional | 55 · Aftercare only | $12.59 | $14.13 | $41.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.33 Typical High $28.18 | Professional | 56 · Pre-op care only | $8.32 | $9.33 | $28.18 |
Where South Dakota sits
The same service costs 3.6 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· 36th 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.