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 $83.18 Median $346.74 Typical High $4,365.16 | Facility | None | $83.18 | $346.74 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $144.54 Typical High $363.08 | Professional | None | $72.44 | $144.54 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $489.78 Typical High $602.56 | Facility | None | $165.96 | $489.78 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $288.40 Typical High $870.96 | Professional | None | $173.78 | $288.40 | $870.96 |
Medica Setting Facility Modifier None Typical Low $123.03 Median $151.36 Typical High $489.78 | Facility | None | $123.03 | $151.36 | $489.78 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $741.31 Typical High $2,454.71 | Professional | None | $295.12 | $741.31 | $2,454.71 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $218.78 Typical High $741.31 | Professional | None | $194.98 | $218.78 | $741.31 |
Midlands Setting Facility Modifier None Typical Low $165.96 Median $177.83 Typical High $223.87 | Facility | None | $165.96 | $177.83 | $223.87 |
Midlands Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $691.83 | Professional | None | $177.83 | $177.83 | $691.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $123.03 Median $331.13 Typical High $602.56 | Professional | None | $123.03 | $331.13 | $602.56 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $104.71 Median $257.04 Typical High $954.99 | Professional | None | $104.71 | $257.04 | $954.99 |
Wellmark Setting Professional Modifier None Typical Low $181.97 Median $213.80 Typical High $954.99 | Professional | None | $181.97 | $213.80 | $954.99 |
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 $36.31 Median $72.44 Typical High $158.49 | Professional | 52 · Reduced service | $36.31 | $72.44 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $28.84 Typical High $63.10 | Professional | 53 · Discontinued | $14.45 | $28.84 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $107.15 Typical High $239.88 | Professional | 54 · Surgery only | $53.70 | $107.15 | $239.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $21.38 Typical High $47.86 | Professional | 55 · Aftercare only | $10.96 | $21.38 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $14.45 Typical High $31.62 | Professional | 56 · Pre-op care only | $7.24 | $14.45 | $31.62 |
Where South Dakota sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 10th of 51
$363
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.