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 $213.80 Median $398.11 Typical High $4,365.16 | Facility | None | $213.80 | $398.11 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $346.74 Typical High $398.11 | Professional | None | $173.78 | $346.74 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $588.84 Median $645.65 Typical High $758.58 | Facility | None | $588.84 | $645.65 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $588.84 Typical High $1,071.52 | Professional | None | $426.58 | $588.84 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $588.84 Typical High $1,202.26 | Facility | None | $295.12 | $588.84 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $870.96 Typical High $3,019.95 | Professional | None | $446.68 | $870.96 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $501.19 Median $524.81 Typical High $870.96 | Professional | None | $501.19 | $524.81 | $870.96 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $645.65 Typical High $812.83 | Facility | None | $645.65 | $645.65 | $812.83 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $812.83 | Professional | None | $436.52 | $436.52 | $812.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $288.40 Median $489.78 Typical High $776.25 | Professional | None | $288.40 | $489.78 | $776.25 |
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 $263.03 Median $562.34 Typical High $1,096.48 | Professional | None | $263.03 | $562.34 | $1,096.48 |
Wellmark Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $1,148.15 | Professional | None | $407.38 | $478.63 | $1,148.15 |
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 $87.10 Median $173.78 Typical High $194.98 | Professional | 52 · Reduced service | $87.10 | $173.78 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $69.18 Typical High $77.62 | Professional | 53 · Discontinued | $35.48 | $69.18 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $263.03 Typical High $288.40 | Professional | 54 · Surgery only | $131.83 | $263.03 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $52.48 Typical High $57.54 | Professional | 55 · Aftercare only | $26.30 | $52.48 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $34.67 Typical High $38.90 | Professional | 56 · Pre-op care only | $17.38 | $34.67 | $38.90 |
Where South Dakota sits
The same service costs 3.8 times more in Alaska 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· 7th of 51
$589
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.