How much rates vary
Facilitymedian $5,888 · 10th to 90th $832 to $14,454Professionalmedian $6,026 · 10th to 90th $724 to $15,488
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 $512.86 Median $4,365.16 Typical High $6,918.31 | Facility | None | $512.86 | $4,365.16 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $489.78 Median $537.03 Typical High $6,456.54 | Professional | None | $489.78 | $537.03 | $6,456.54 |
Cigna Setting Facility Modifier None Typical Low $7,762.47 Median $9,549.93 Typical High $16,982.44 | Facility | None | $7,762.47 | $9,549.93 | $16,982.44 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $15,488.17 | Professional | None | $1,122.02 | $1,412.54 | $15,488.17 |
Medica Setting Facility Modifier None Typical Low $831.76 Median $5,888.44 Typical High $9,332.54 | Facility | None | $831.76 | $5,888.44 | $9,332.54 |
Medica Setting Professional Modifier None Typical Low $5,623.41 Median $14,454.40 Typical High $18,197.01 | Professional | None | $5,623.41 | $14,454.40 | $18,197.01 |
Midlands Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $14,791.08 | Professional | None | $1,202.26 | $1,202.26 | $14,791.08 |
Midlands Setting Facility Modifier None Typical Low $14,454.40 Median $16,595.87 Typical High $19,952.62 | Facility | None | $14,454.40 | $16,595.87 | $19,952.62 |
Sanford Health Plan Setting Professional Modifier None Typical Low $724.44 Median $7,244.36 Typical High $10,000.00 | Professional | None | $724.44 | $7,244.36 | $10,000.00 |
United Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,760.83 | Facility | None | $5,623.41 | $5,623.41 | $6,760.83 |
United Setting Professional Modifier None Typical Low $575.44 Median $1,412.54 Typical High $18,197.01 | Professional | None | $575.44 | $1,412.54 | $18,197.01 |
Wellmark Setting Professional Modifier None Typical Low $933.25 Median $1,148.15 Typical High $15,135.61 | Professional | None | $933.25 | $1,148.15 | $15,135.61 |
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 $245.47 Median $269.15 Typical High $3,019.95 | Professional | 52 · Reduced service | $245.47 | $269.15 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $97.72 Median $107.15 Typical High $1,202.26 | Professional | 53 · Discontinued | $97.72 | $107.15 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $363.08 Median $407.38 Typical High $4,466.84 | Professional | 54 · Surgery only | $363.08 | $407.38 | $4,466.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $72.44 Median $81.28 Typical High $891.25 | Professional | 55 · Aftercare only | $72.44 | $81.28 | $891.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $48.98 Median $53.70 Typical High $602.56 | Professional | 56 · Pre-op care only | $48.98 | $53.70 | $602.56 |
Where South Dakota sits
The same service costs 6.1 times more in Alaska than in Vermont. 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.
Physician feeFacility fee
AK $33,081VT $5,424
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.