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 $85.11 Median $977.24 Typical High $4,365.16 | Facility | None | $85.11 | $977.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $141.25 Typical High $891.25 | Professional | None | $70.79 | $141.25 | $891.25 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $851.14 Typical High $1,698.24 | Facility | None | $660.69 | $851.14 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $302.00 Typical High $2,454.71 | Professional | None | $173.78 | $302.00 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $120.23 Median $891.25 Typical High $1,412.54 | Facility | None | $120.23 | $891.25 | $1,412.54 |
Medica Setting Professional Modifier None Typical Low $831.76 Median $2,089.30 Typical High $6,918.31 | Professional | None | $831.76 | $2,089.30 | $6,918.31 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $213.80 Typical High $2,089.30 | Professional | None | $194.98 | $213.80 | $2,089.30 |
Midlands Setting Facility Modifier None Typical Low $660.69 Median $758.58 Typical High $1,047.13 | Facility | None | $660.69 | $758.58 | $1,047.13 |
Midlands Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $1,949.84 | Professional | None | $177.83 | $177.83 | $1,949.84 |
Sanford Health Plan Setting Professional Modifier None Typical Low $117.49 Median $1,096.48 Typical High $1,659.59 | Professional | None | $117.49 | $1,096.48 | $1,659.59 |
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 $102.33 Median $269.15 Typical High $2,754.23 | Professional | None | $102.33 | $269.15 | $2,754.23 |
Wellmark Setting Professional Modifier None Typical Low $177.83 Median $204.17 Typical High $2,630.27 | Professional | None | $177.83 | $204.17 | $2,630.27 |
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 $35.48 Median $70.79 Typical High $446.68 | Professional | 52 · Reduced service | $35.48 | $70.79 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.45 Median $28.18 Typical High $177.83 | Professional | 53 · Discontinued | $14.45 | $28.18 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $107.15 Typical High $676.08 | Professional | 54 · Surgery only | $53.70 | $107.15 | $676.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $21.38 Typical High $134.90 | Professional | 55 · Aftercare only | $10.72 | $21.38 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $14.13 Typical High $89.13 | Professional | 56 · Pre-op care only | $7.08 | $14.13 | $89.13 |
Where South Dakota sits
The same service costs 14.1 times more in Washington than in Kentucky. 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· 8th of 51
$1,000
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.