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 $85.11 Median $190.55 Typical High $4,365.16 | Facility | None | $85.11 | $190.55 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $125.89 Typical High $213.80 | Professional | None | $83.18 | $125.89 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $724.44 Typical High $2,187.76 | Facility | None | $275.42 | $724.44 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $309.03 Typical High $549.54 | Professional | None | $190.55 | $309.03 | $549.54 |
Medica Setting Facility Modifier None Typical Low $141.25 Median $323.59 Typical High $660.69 | Facility | None | $141.25 | $323.59 | $660.69 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $512.86 Typical High $2,344.23 | Professional | None | $223.87 | $512.86 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $436.52 | Professional | None | $204.17 | $204.17 | $436.52 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $724.44 Typical High $2,187.76 | Facility | None | $645.65 | $724.44 | $2,187.76 |
Sanford Health Plan Setting Professional Modifier None Typical Low $134.90 Median $263.03 Typical High $354.81 | Professional | None | $134.90 | $263.03 | $354.81 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $125.89 Median $234.42 Typical High $537.03 | Professional | None | $125.89 | $234.42 | $537.03 |
Wellmark Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $549.54 | Professional | None | $165.96 | $204.17 | $549.54 |
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 $107.15 | Professional | 52 · Reduced service | $41.69 | $46.77 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $18.62 Typical High $42.66 | Professional | 53 · Discontinued | $16.60 | $18.62 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $69.18 Typical High $158.49 | Professional | 54 · Surgery only | $63.10 | $69.18 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.80 Typical High $31.62 | Professional | 55 · Aftercare only | $12.59 | $13.80 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $9.33 Typical High $21.38 | Professional | 56 · Pre-op care only | $8.32 | $9.33 | $21.38 |
Where South Dakota sits
The same service costs 4.1 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· 23rd of 51
$288
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.