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 $239.88 Median $2,290.87 Typical High $4,365.16 | Facility | None | $239.88 | $2,290.87 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $239.88 | Professional | None | $204.17 | $204.17 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $1,479.11 Typical High $1,737.80 | Facility | None | $354.81 | $1,479.11 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $398.11 Median $549.54 Typical High $707.95 | Professional | None | $398.11 | $549.54 | $707.95 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $562.34 Typical High $1,819.70 | Facility | None | $295.12 | $562.34 | $1,819.70 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $549.54 Typical High $1,819.70 | Professional | None | $263.03 | $549.54 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $549.54 | Professional | None | $489.78 | $549.54 | $549.54 |
Midlands Setting Facility Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $2,398.83 | Facility | None | $1,445.44 | $1,659.59 | $2,398.83 |
Midlands Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Sanford Health Plan Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $257.04 | Professional | None | $257.04 | $257.04 | $257.04 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,513.56 | $1,513.56 | $1,819.70 |
United Setting Professional Modifier None Typical Low $234.42 Median $478.63 Typical High $660.69 | Professional | None | $234.42 | $478.63 | $660.69 |
Wellmark Setting Professional Modifier None Typical Low $398.11 Median $467.74 Typical High $467.74 | Professional | None | $398.11 | $467.74 | $467.74 |
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 $102.33 Median $102.33 Typical High $120.23 | Professional | 52 · Reduced service | $102.33 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $40.74 Typical High $47.86 | Professional | 53 · Discontinued | $40.74 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $181.97 | Professional | 54 · Surgery only | $154.88 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $30.90 Typical High $36.31 | Professional | 55 · Aftercare only | $30.90 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $20.42 Typical High $23.99 | Professional | 56 · Pre-op care only | $20.42 | $20.42 | $23.99 |
Where South Dakota sits
The same service costs 4.6 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
$501
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.