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 $81.28 Median $181.97 Typical High $4,365.16 | Facility | None | $81.28 | $181.97 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $138.04 Typical High $194.98 | Professional | None | $69.18 | $138.04 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $660.69 Typical High $1,862.09 | Facility | None | $295.12 | $660.69 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $251.19 Typical High $524.81 | Professional | None | $165.96 | $251.19 | $524.81 |
Medica Setting Facility Modifier None Typical Low $117.49 Median $295.12 Typical High $1,202.26 | Facility | None | $117.49 | $295.12 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $389.05 Typical High $1,479.11 | Professional | None | $186.21 | $389.05 | $1,479.11 |
Midlands Setting Professional Modifier None Typical Low $186.21 Median $208.93 Typical High $389.05 | Professional | None | $186.21 | $208.93 | $389.05 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $660.69 Typical High $1,949.84 | Facility | None | $645.65 | $660.69 | $1,949.84 |
Midlands Setting Professional Modifier None Typical Low $177.83 Median $177.83 Typical High $380.19 | Professional | None | $177.83 | $177.83 | $380.19 |
Sanford Health Plan Setting Professional Modifier None Typical Low $123.03 Median $213.80 Typical High $371.54 | Professional | None | $123.03 | $213.80 | $371.54 |
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 $97.72 Median $218.78 Typical High $512.86 | Professional | None | $97.72 | $218.78 | $512.86 |
Wellmark Setting Professional Modifier None Typical Low $181.97 Median $208.93 Typical High $575.44 | Professional | None | $181.97 | $208.93 | $575.44 |
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 $34.67 Median $69.18 Typical High $97.72 | Professional | 52 · Reduced service | $34.67 | $69.18 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $27.54 Typical High $38.90 | Professional | 53 · Discontinued | $13.80 | $27.54 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $104.71 Typical High $144.54 | Professional | 54 · Surgery only | $51.29 | $104.71 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $20.89 Typical High $28.84 | Professional | 55 · Aftercare only | $10.23 | $20.89 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $13.80 Typical High $19.50 | Professional | 56 · Pre-op care only | $6.92 | $13.80 | $19.50 |
Where South Dakota sits
The same service costs 4.5 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· 11th of 51
$234
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.