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 $47.86 Median $125.89 Typical High $4,365.16 | Facility | None | $47.86 | $125.89 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $100.00 Typical High $158.49 | Professional | None | $40.74 | $100.00 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $120.23 Median $151.36 Typical High $239.88 | Facility | None | $120.23 | $151.36 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $158.49 Typical High $346.74 | Professional | None | $97.72 | $158.49 | $346.74 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $190.55 Typical High $549.54 | Facility | None | $67.61 | $190.55 | $549.54 |
Medica Setting Professional Modifier None Typical Low $112.20 Median $275.42 Typical High $954.99 | Professional | None | $112.20 | $275.42 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $112.20 Median $120.23 Typical High $275.42 | Professional | None | $112.20 | $120.23 | $275.42 |
Midlands Setting Facility Modifier None Typical Low $120.23 Median $147.91 Typical High $190.55 | Facility | None | $120.23 | $147.91 | $190.55 |
Midlands Setting Professional Modifier None Typical Low $100.00 Median $100.00 Typical High $251.19 | Professional | None | $100.00 | $100.00 | $251.19 |
Sanford Health Plan Setting Professional Modifier None Typical Low $70.79 Median $151.36 Typical High $239.88 | Professional | None | $70.79 | $151.36 | $239.88 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $61.66 Median $131.83 Typical High $346.74 | Professional | None | $61.66 | $131.83 | $346.74 |
Wellmark Setting Professional Modifier None Typical Low $100.00 Median $114.82 Typical High $380.19 | Professional | None | $100.00 | $114.82 | $380.19 |
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 $19.95 Median $40.74 Typical High $63.10 | Professional | 52 · Reduced service | $19.95 | $40.74 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $16.22 Typical High $25.12 | Professional | 53 · Discontinued | $8.13 | $16.22 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $60.26 Typical High $95.50 | Professional | 54 · Surgery only | $30.20 | $60.26 | $95.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $12.02 Typical High $19.05 | Professional | 55 · Aftercare only | $6.03 | $12.02 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $8.13 Typical High $12.59 | Professional | 56 · Pre-op care only | $4.07 | $8.13 | $12.59 |
Where South Dakota sits
The same service costs 3.5 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· 9th of 51
$148
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.