How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $109.65 Median $3,090.30 Typical High $4,365.16 | Facility | None | $109.65 | $3,090.30 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $120.23 | Professional | None | $104.71 | $104.71 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $154.88 Median $316.23 Typical High $870.96 | Facility | None | $154.88 | $316.23 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $251.19 Typical High $309.03 | Professional | None | $173.78 | $251.19 | $309.03 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $257.04 | Facility | None | $125.89 | $151.36 | $257.04 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $257.04 Typical High $891.25 | Professional | None | $104.71 | $257.04 | $891.25 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $257.04 | Professional | None | $218.78 | $257.04 | $257.04 |
Midlands Setting Facility Modifier None Typical Low $295.12 Median $389.05 Typical High $977.24 | Facility | None | $295.12 | $389.05 | $977.24 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $208.93 | Professional | None | $208.93 | $208.93 | $208.93 |
Sanford Health Plan Setting Professional Modifier None Typical Low $107.15 Median $144.54 Typical High $208.93 | Professional | None | $107.15 | $144.54 | $208.93 |
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 $97.72 Median $190.55 Typical High $302.00 | Professional | None | $97.72 | $190.55 | $302.00 |
Wellmark Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $223.87 | Professional | None | $181.97 | $223.87 | $223.87 |
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 $52.48 Median $52.48 Typical High $60.26 | Professional | 52 · Reduced service | $52.48 | $52.48 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $20.89 Typical High $23.99 | Professional | 53 · Discontinued | $20.89 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $79.43 Typical High $89.13 | Professional | 54 · Surgery only | $79.43 | $79.43 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $15.85 Typical High $18.20 | Professional | 55 · Aftercare only | $15.85 | $15.85 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $10.47 Typical High $12.02 | Professional | 56 · Pre-op care only | $10.47 | $10.47 | $12.02 |
Where South Dakota sits
The same service costs 4.8 times more in Alaska 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· 5th of 51
$219
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.