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 $371.54 Median $371.54 Typical High $4,365.16 | Facility | None | $371.54 | $371.54 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $371.54 | Professional | None | $302.00 | $302.00 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $512.86 Median $512.86 Typical High $645.65 | Facility | None | $512.86 | $512.86 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,023.29 | Professional | None | $575.44 | $851.14 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $758.58 Typical High $1,202.26 | Facility | None | $478.63 | $758.58 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $851.14 Typical High $2,754.23 | Professional | None | $398.11 | $851.14 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Professional | None | $812.83 | $812.83 | $812.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $446.68 Median $549.54 Typical High $741.31 | Professional | None | $446.68 | $549.54 | $741.31 |
United Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $1,202.26 | Facility | None | $758.58 | $758.58 | $1,202.26 |
United Setting Professional Modifier None Typical Low $363.08 Median $724.44 Typical High $1,023.29 | Professional | None | $363.08 | $724.44 | $1,023.29 |
Wellmark Setting Professional Modifier None Typical Low $758.58 Median $870.96 Typical High $870.96 | Professional | None | $758.58 | $870.96 | $870.96 |
3 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 54 · Surgery only Typical Low $229.09 Median $229.09 Typical High $281.84 | Professional | 54 · Surgery only | $229.09 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $45.71 Typical High $56.23 | Professional | 55 · Aftercare only | $45.71 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $30.20 Typical High $37.15 | Professional | 56 · Pre-op care only | $30.20 | $30.20 | $37.15 |
Where South Dakota sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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
$813
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.