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 $363.08 Median $3,090.30 Typical High $4,365.16 | Facility | None | $363.08 | $3,090.30 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $363.08 | Professional | None | $295.12 | $295.12 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $501.19 Median $1,202.26 Typical High $1,862.09 | Facility | None | $501.19 | $1,202.26 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,000.00 | Professional | None | $575.44 | $812.83 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $812.83 Typical High $1,819.70 | Facility | None | $467.74 | $812.83 | $1,819.70 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $851.14 Typical High $2,818.38 | Professional | None | $407.38 | $851.14 | $2,818.38 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $851.14 Typical High $851.14 | Professional | None | $776.25 | $851.14 | $851.14 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,445.44 Typical High $1,862.09 | Facility | None | $954.99 | $1,445.44 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $741.31 | Professional | None | $741.31 | $741.31 | $741.31 |
Sanford Health Plan Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $676.08 | Professional | None | $457.09 | $537.03 | $676.08 |
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 $398.11 Median $724.44 Typical High $1,000.00 | Professional | None | $398.11 | $724.44 | $1,000.00 |
Wellmark Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $794.33 | Professional | None | $691.83 | $794.33 | $794.33 |
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 $147.91 Median $147.91 Typical High $177.83 | Professional | 52 · Reduced service | $147.91 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $58.88 Typical High $72.44 | Professional | 53 · Discontinued | $58.88 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $223.87 Median $223.87 Typical High $269.15 | Professional | 54 · Surgery only | $223.87 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $44.67 Typical High $53.70 | Professional | 55 · Aftercare only | $44.67 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $29.51 Typical High $36.31 | Professional | 56 · Pre-op care only | $29.51 | $29.51 | $36.31 |
Where South Dakota sits
The same service costs 4.8 times more in Alaska than in Utah. 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
$794
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.