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 $407.38 Median $4,365.16 Typical High $4,897.79 | Facility | None | $407.38 | $4,365.16 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $338.84 Median $338.84 Typical High $407.38 | Professional | None | $338.84 | $338.84 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,949.84 Typical High $3,388.44 | Facility | None | $575.44 | $1,949.84 | $3,388.44 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $933.25 Typical High $1,148.15 | Professional | None | $660.69 | $933.25 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $537.03 Median $933.25 Typical High $2,398.83 | Facility | None | $537.03 | $933.25 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $954.99 Typical High $3,311.31 | Professional | None | $457.09 | $954.99 | $3,311.31 |
Midlands Setting Professional Modifier None Typical Low $891.25 Median $954.99 Typical High $954.99 | Professional | None | $891.25 | $954.99 | $954.99 |
Midlands Setting Facility Modifier None Typical Low $1,949.84 Median $2,570.40 Typical High $6,165.95 | Facility | None | $1,949.84 | $2,570.40 | $6,165.95 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Sanford Health Plan Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $776.25 | Professional | None | $426.58 | $575.44 | $776.25 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Facility | None | $1,995.26 | $1,995.26 | $2,398.83 |
United Setting Professional Modifier None Typical Low $426.58 Median $831.76 Typical High $1,148.15 | Professional | None | $426.58 | $831.76 | $1,148.15 |
Wellmark Setting Professional Modifier None Typical Low $794.33 Median $912.01 Typical High $912.01 | Professional | None | $794.33 | $912.01 | $912.01 |
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 $169.82 Median $169.82 Typical High $204.17 | Professional | 52 · Reduced service | $169.82 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $67.61 Median $67.61 Typical High $83.18 | Professional | 53 · Discontinued | $67.61 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $257.04 Typical High $309.03 | Professional | 54 · Surgery only | $257.04 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $51.29 Median $51.29 Typical High $61.66 | Professional | 55 · Aftercare only | $51.29 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.88 Median $33.88 Typical High $40.74 | Professional | 56 · Pre-op care only | $33.88 | $33.88 | $40.74 |
Where South Dakota sits
The same service costs 4.5 times more in Alaska than in Texas. 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
$912
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.