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 $131.83 Median $309.03 Typical High $4,365.16 | Facility | None | $131.83 | $309.03 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $281.84 Typical High $436.52 | Professional | None | $123.03 | $281.84 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $489.78 Typical High $2,570.40 | Facility | None | $398.11 | $489.78 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $562.34 Typical High $794.33 | Professional | None | $281.84 | $562.34 | $794.33 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $223.87 Typical High $602.56 | Facility | None | $125.89 | $223.87 | $602.56 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $812.83 Typical High $2,398.83 | Professional | None | $316.23 | $812.83 | $2,398.83 |
Midlands Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $676.08 | Professional | None | $309.03 | $309.03 | $676.08 |
Midlands Setting Facility Modifier None Typical Low $1,819.70 Median $2,570.40 Typical High $2,570.40 | Facility | None | $1,819.70 | $2,570.40 | $2,570.40 |
Sanford Health Plan Setting Professional Modifier None Typical Low $208.93 Median $398.11 Typical High $537.03 | Professional | None | $208.93 | $398.11 | $537.03 |
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 $165.96 Median $363.08 Typical High $851.14 | Professional | None | $165.96 | $363.08 | $851.14 |
Wellmark Setting Professional Modifier None Typical Low $245.47 Median $302.00 Typical High $707.95 | Professional | None | $245.47 | $302.00 | $707.95 |
3 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 54 · Surgery only Typical Low $93.33 Median $102.33 Typical High $229.09 | Professional | 54 · Surgery only | $93.33 | $102.33 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $20.42 Typical High $45.71 | Professional | 55 · Aftercare only | $18.62 | $20.42 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $13.80 Typical High $30.90 | Professional | 56 · Pre-op care only | $12.30 | $13.80 | $30.90 |
Where South Dakota sits
The same service costs 3.4 times more in Alaska 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· 24th of 51
$363
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.