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 $109.65 Median $204.17 Typical High $4,365.16 | Facility | None | $109.65 | $204.17 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $186.21 Typical High $208.93 | Professional | None | $93.33 | $186.21 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $660.69 Typical High $851.14 | Facility | None | $323.59 | $660.69 | $851.14 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $562.34 | Professional | None | $223.87 | $316.23 | $562.34 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $323.59 Typical High $1,202.26 | Facility | None | $154.88 | $323.59 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $436.52 Typical High $1,621.81 | Professional | None | $213.80 | $436.52 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $436.52 | Professional | None | $257.04 | $275.42 | $436.52 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $660.69 Typical High $891.25 | Facility | None | $645.65 | $660.69 | $891.25 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $416.87 | Professional | None | $229.09 | $229.09 | $416.87 |
Sanford Health Plan Setting Professional Modifier None Typical Low $158.49 Median $251.19 Typical High $407.38 | Professional | None | $158.49 | $251.19 | $407.38 |
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 $131.83 Median $288.40 Typical High $562.34 | Professional | None | $131.83 | $288.40 | $562.34 |
Wellmark Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $616.60 | Professional | None | $229.09 | $263.03 | $616.60 |
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 $46.77 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $46.77 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $37.15 Typical High $41.69 | Professional | 53 · Discontinued | $18.62 | $37.15 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $138.04 Typical High $158.49 | Professional | 54 · Surgery only | $69.18 | $138.04 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $27.54 Typical High $31.62 | Professional | 55 · Aftercare only | $13.80 | $27.54 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $18.62 Typical High $20.89 | Professional | 56 · Pre-op care only | $9.33 | $18.62 | $20.89 |
Where South Dakota sits
The same service costs 3.8 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
$309
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.