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 $229.09 Median $2,290.87 Typical High $4,365.16 | Facility | None | $229.09 | $2,290.87 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $229.09 | Professional | None | $190.55 | $190.55 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $891.25 | Facility | None | $323.59 | $407.38 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $537.03 Typical High $645.65 | Professional | None | $371.54 | $537.03 | $645.65 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $524.81 Typical High $1,202.26 | Facility | None | $302.00 | $524.81 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $489.78 Typical High $1,698.24 | Professional | None | $275.42 | $489.78 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $537.03 Median $537.03 Typical High $537.03 | Professional | None | $537.03 | $537.03 | $537.03 |
Midlands Setting Facility Modifier None Typical Low $691.83 Median $851.14 Typical High $1,047.13 | Facility | None | $691.83 | $851.14 | $1,047.13 |
Sanford Health Plan Setting Professional Modifier None Typical Low $288.40 Median $363.08 Typical High $436.52 | Professional | None | $288.40 | $363.08 | $436.52 |
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 $251.19 Median $457.09 Typical High $645.65 | Professional | None | $251.19 | $457.09 | $645.65 |
Wellmark Setting Professional Modifier None Typical Low $446.68 Median $512.86 Typical High $512.86 | Professional | None | $446.68 | $512.86 | $512.86 |
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 $95.50 Median $95.50 Typical High $114.82 | Professional | 52 · Reduced service | $95.50 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $38.02 Typical High $45.71 | Professional | 53 · Discontinued | $38.02 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $144.54 Typical High $173.78 | Professional | 54 · Surgery only | $144.54 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $28.84 Typical High $34.67 | Professional | 55 · Aftercare only | $28.84 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $19.05 Typical High $22.91 | Professional | 56 · Pre-op care only | $19.05 | $19.05 | $22.91 |
Where South Dakota sits
The same service costs 4.7 times more in Wyoming 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· 6th of 51
$513
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.