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 $81.28 Median $194.98 Typical High $4,365.16 | Facility | None | $81.28 | $194.98 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $67.61 Median $134.90 Typical High $194.98 | Professional | None | $67.61 | $134.90 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $218.78 Typical High $354.81 | Facility | None | $190.55 | $218.78 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $251.19 Typical High $501.19 | Professional | None | $162.18 | $251.19 | $501.19 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $281.84 Typical High $1,202.26 | Facility | None | $114.82 | $281.84 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $190.55 Median $426.58 Typical High $1,412.54 | Professional | None | $190.55 | $426.58 | $1,412.54 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $204.17 Typical High $426.58 | Professional | None | $190.55 | $204.17 | $426.58 |
Midlands Setting Facility Modifier None Typical Low $190.55 Median $199.53 Typical High $229.09 | Facility | None | $190.55 | $199.53 | $229.09 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $380.19 | Professional | None | $169.82 | $169.82 | $380.19 |
Sanford Health Plan Setting Professional Modifier None Typical Low $117.49 Median $229.09 Typical High $363.08 | Professional | None | $117.49 | $229.09 | $363.08 |
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 $104.71 Median $229.09 Typical High $537.03 | Professional | None | $104.71 | $229.09 | $537.03 |
Wellmark Setting Professional Modifier None Typical Low $151.36 Median $173.78 Typical High $501.19 | Professional | None | $151.36 | $173.78 | $501.19 |
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 $33.88 Median $67.61 Typical High $93.33 | Professional | 52 · Reduced service | $33.88 | $67.61 | $93.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $27.54 Typical High $37.15 | Professional | 53 · Discontinued | $13.49 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $102.33 Typical High $141.25 | Professional | 54 · Surgery only | $51.29 | $102.33 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $20.42 Typical High $28.18 | Professional | 55 · Aftercare only | $10.23 | $20.42 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $13.49 Typical High $18.62 | Professional | 56 · Pre-op care only | $6.76 | $13.49 | $18.62 |
Where South Dakota sits
The same service costs 3.7 times more in Alaska 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· 11th of 51
$234
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.