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 $91.20 Median $446.68 Typical High $4,365.16 | Facility | None | $91.20 | $446.68 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $97.72 Typical High $426.58 | Professional | None | $77.62 | $97.72 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $446.68 Median $549.54 Typical High $691.83 | Facility | None | $446.68 | $549.54 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $181.97 Median $616.60 Typical High $1,096.48 | Professional | None | $181.97 | $616.60 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $131.83 Median $512.86 Typical High $758.58 | Facility | None | $131.83 | $512.86 | $758.58 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $891.25 Typical High $1,230.27 | Professional | None | $380.19 | $891.25 | $1,230.27 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $954.99 | Professional | None | $218.78 | $218.78 | $954.99 |
Midlands Setting Facility Modifier None Typical Low $446.68 Median $467.74 Typical High $549.54 | Facility | None | $446.68 | $467.74 | $549.54 |
Sanford Health Plan Setting Professional Modifier None Typical Low $114.82 Median $363.08 Typical High $707.95 | Professional | None | $114.82 | $363.08 | $707.95 |
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 $104.71 Median $257.04 Typical High $1,230.27 | Professional | None | $104.71 | $257.04 | $1,230.27 |
Wellmark Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $933.25 | Professional | None | $154.88 | $186.21 | $933.25 |
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 $38.90 Median $45.71 Typical High $213.80 | Professional | 52 · Reduced service | $38.90 | $45.71 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $18.20 Typical High $85.11 | Professional | 53 · Discontinued | $15.49 | $18.20 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $69.18 Typical High $323.59 | Professional | 54 · Surgery only | $58.88 | $69.18 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.80 Typical High $64.57 | Professional | 55 · Aftercare only | $11.75 | $13.80 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $9.12 Typical High $42.66 | Professional | 56 · Pre-op care only | $7.76 | $9.12 | $42.66 |
Where South Dakota sits
The same service costs 7.8 times more in Oklahoma 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· 20th of 51
$468
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.