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 $64.57 Median $154.88 Typical High $4,365.16 | Facility | None | $64.57 | $154.88 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $147.91 | Professional | None | $51.29 | $64.57 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $446.68 | Professional | None | $141.25 | $173.78 | $446.68 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $190.55 Typical High $363.08 | Facility | None | $83.18 | $190.55 | $363.08 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $338.84 Typical High $2,951.21 | Professional | None | $151.36 | $338.84 | $2,951.21 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $154.88 Typical High $338.84 | Professional | None | $151.36 | $154.88 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $131.83 Typical High $302.00 | Professional | None | $123.03 | $131.83 | $302.00 |
Sanford Health Plan Setting Professional Modifier None Typical Low $74.13 Median $165.96 Typical High $275.42 | Professional | None | $74.13 | $165.96 | $275.42 |
United Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
United Setting Professional Modifier None Typical Low $81.28 Median $177.83 Typical High $436.52 | Professional | None | $81.28 | $177.83 | $436.52 |
Wellmark Setting Professional Modifier None Typical Low $114.82 Median $131.83 Typical High $371.54 | Professional | None | $114.82 | $131.83 | $371.54 |
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 $25.70 Median $32.36 Typical High $74.13 | Professional | 52 · Reduced service | $25.70 | $32.36 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $12.88 Typical High $29.51 | Professional | 53 · Discontinued | $10.23 | $12.88 | $29.51 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $47.86 Typical High $109.65 | Professional | 54 · Surgery only | $38.90 | $47.86 | $109.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $9.55 Typical High $21.88 | Professional | 55 · Aftercare only | $7.76 | $9.55 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.46 Typical High $14.79 | Professional | 56 · Pre-op care only | $5.13 | $6.46 | $14.79 |
Where South Dakota sits
The same service costs 3.7 times more in Wisconsin than in Maryland. 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· 12th of 51
$178
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.