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 $57.54 Median $79.43 Typical High $4,365.16 | Facility | None | $57.54 | $79.43 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $51.29 Median $64.57 Typical High $100.00 | Professional | None | $51.29 | $64.57 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $77.62 Typical High $138.04 | Facility | None | $67.61 | $77.62 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $213.80 | Professional | None | $112.20 | $154.88 | $213.80 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $109.65 Typical High $1,202.26 | Facility | None | $77.62 | $109.65 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $186.21 Typical High $549.54 | Professional | None | $93.33 | $186.21 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $131.83 Median $151.36 Typical High $186.21 | Professional | None | $131.83 | $151.36 | $186.21 |
Midlands Setting Facility Modifier None Typical Low $64.57 Median $70.79 Typical High $91.20 | Facility | None | $64.57 | $70.79 | $91.20 |
Midlands Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $162.18 | Professional | None | $120.23 | $120.23 | $162.18 |
Sanford Health Plan Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $144.54 | Professional | None | $75.86 | $109.65 | $144.54 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $69.18 Median $128.82 Typical High $218.78 | Professional | None | $69.18 | $128.82 | $218.78 |
Wellmark Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $194.98 | Professional | None | $117.49 | $134.90 | $194.98 |
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 $25.12 Median $32.36 Typical High $38.02 | Professional | 52 · Reduced service | $25.12 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $12.88 Typical High $15.14 | Professional | 53 · Discontinued | $10.23 | $12.88 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $48.98 Typical High $56.23 | Professional | 54 · Surgery only | $38.02 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $9.77 Typical High $11.48 | Professional | 55 · Aftercare only | $7.59 | $9.77 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $6.46 Typical High $7.59 | Professional | 56 · Pre-op care only | $5.13 | $6.46 | $7.59 |
Where South Dakota sits
The same service costs 4.3 times more in Alaska than in New Jersey. 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· 6th of 51
$135
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.