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 $39.81 Median $158.49 Typical High $4,365.16 | Facility | None | $39.81 | $158.49 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $67.61 Typical High $154.88 | Professional | None | $34.67 | $67.61 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $239.88 Typical High $302.00 | Facility | None | $100.00 | $239.88 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $151.36 Typical High $436.52 | Professional | None | $83.18 | $151.36 | $436.52 |
Medica Setting Facility Modifier None Typical Low $58.88 Median $239.88 Typical High $549.54 | Facility | None | $58.88 | $239.88 | $549.54 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $354.81 Typical High $1,202.26 | Professional | None | $109.65 | $354.81 | $1,202.26 |
Midlands Setting Professional Modifier None Typical Low $93.33 Median $102.33 Typical High $354.81 | Professional | None | $93.33 | $102.33 | $354.81 |
Midlands Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Midlands Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $316.23 | Professional | None | $83.18 | $83.18 | $316.23 |
Sanford Health Plan Setting Professional Modifier None Typical Low $54.95 Median $190.55 Typical High $288.40 | Professional | None | $54.95 | $190.55 | $288.40 |
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 $47.86 Median $112.20 Typical High $446.68 | Professional | None | $47.86 | $112.20 | $446.68 |
Wellmark Setting Professional Modifier None Typical Low $83.18 Median $95.50 Typical High $426.58 | Professional | None | $83.18 | $95.50 | $426.58 |
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 $17.38 Median $33.88 Typical High $77.62 | Professional | 52 · Reduced service | $17.38 | $33.88 | $77.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $13.80 Typical High $31.62 | Professional | 53 · Discontinued | $6.92 | $13.80 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $51.29 Typical High $117.49 | Professional | 54 · Surgery only | $26.30 | $51.29 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $10.23 Typical High $23.44 | Professional | 55 · Aftercare only | $5.25 | $10.23 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $6.76 Typical High $15.49 | Professional | 56 · Pre-op care only | $3.47 | $6.76 | $15.49 |
Where South Dakota sits
The same service costs 4.6 times more in Wisconsin 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· 6th of 51
$191
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.