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 $54.95 Median $83.18 Typical High $4,365.16 | Facility | None | $54.95 | $83.18 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $61.66 Typical High $97.72 | Professional | None | $53.70 | $61.66 | $97.72 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $158.49 | Facility | None | $128.82 | $128.82 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $151.36 Typical High $257.04 | Professional | None | $120.23 | $151.36 | $257.04 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $125.89 Typical High $239.88 | Facility | None | $89.13 | $125.89 | $239.88 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $223.87 Typical High $1,023.29 | Professional | None | $93.33 | $223.87 | $1,023.29 |
Midlands Setting Professional Modifier None Typical Low $128.82 Median $128.82 Typical High $190.55 | Professional | None | $128.82 | $128.82 | $190.55 |
Sanford Health Plan Setting Professional Modifier None Typical Low $72.44 Median $112.20 Typical High $165.96 | Professional | None | $72.44 | $112.20 | $165.96 |
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 $66.07 Median $151.36 Typical High $234.42 | Professional | None | $66.07 | $151.36 | $234.42 |
Wellmark Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $218.78 | Professional | None | $93.33 | $114.82 | $218.78 |
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 $26.30 Median $29.51 Typical High $48.98 | Professional | 52 · Reduced service | $26.30 | $29.51 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.72 Median $11.75 Typical High $19.95 | Professional | 53 · Discontinued | $10.72 | $11.75 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $39.81 Median $43.65 Typical High $74.13 | Professional | 54 · Surgery only | $39.81 | $43.65 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.94 Median $8.71 Typical High $14.79 | Professional | 55 · Aftercare only | $7.94 | $8.71 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $5.89 Typical High $9.77 | Professional | 56 · Pre-op care only | $5.37 | $5.89 | $9.77 |
Where South Dakota sits
The same service costs 3.7 times more in Wisconsin 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· 10th of 51
$135
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.