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 $269.15 Median $1,071.52 Typical High $4,365.16 | Facility | None | $269.15 | $1,071.52 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $812.83 Typical High $1,380.38 | Professional | None | $263.03 | $812.83 | $1,380.38 |
Cigna Setting Facility Modifier None Typical Low $1,412.54 Median $1,819.70 Typical High $2,187.76 | Facility | None | $1,412.54 | $1,819.70 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $758.58 Typical High $2,818.38 | Professional | None | $602.56 | $758.58 | $2,818.38 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $1,659.59 Typical High $2,398.83 | Facility | None | $446.68 | $1,659.59 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $1,318.26 Median $2,884.03 Typical High $11,220.18 | Professional | None | $1,318.26 | $2,884.03 | $11,220.18 |
Midlands Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $2,570.40 | Professional | None | $630.96 | $630.96 | $2,570.40 |
Midlands Setting Facility Modifier None Typical Low $1,819.70 Median $2,187.76 Typical High $2,570.40 | Facility | None | $1,819.70 | $2,187.76 | $2,570.40 |
Sanford Health Plan Setting Professional Modifier None Typical Low $436.52 Median $1,380.38 Typical High $2,089.30 | Professional | None | $436.52 | $1,380.38 | $2,089.30 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Facility | None | $1,995.26 | $1,995.26 | $2,398.83 |
United Setting Professional Modifier None Typical Low $338.84 Median $758.58 Typical High $3,019.95 | Professional | None | $338.84 | $758.58 | $3,019.95 |
Wellmark Setting Professional Modifier None Typical Low $512.86 Median $630.96 Typical High $2,511.89 | Professional | None | $512.86 | $630.96 | $2,511.89 |
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 $194.98 Median $218.78 Typical High $812.83 | Professional | 54 · Surgery only | $194.98 | $218.78 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.90 Median $43.65 Typical High $162.18 | Professional | 55 · Aftercare only | $38.90 | $43.65 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.84 Typical High $109.65 | Professional | 56 · Pre-op care only | $26.30 | $28.84 | $109.65 |
Where South Dakota sits
The same service costs 4.8 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· 16th of 51
$1,445
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.