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 $64.57 Median $147.91 Typical High $4,365.16 | Facility | None | $64.57 | $147.91 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $53.70 Median $128.82 Typical High $173.78 | Professional | None | $53.70 | $128.82 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $194.98 Typical High $309.03 | Facility | None | $114.82 | $194.98 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $436.52 | Professional | None | $131.83 | $204.17 | $436.52 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $245.47 Typical High $1,202.26 | Facility | None | $91.20 | $245.47 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $147.91 Median $316.23 Typical High $1,230.27 | Professional | None | $147.91 | $316.23 | $1,230.27 |
Midlands Setting Professional Modifier None Typical Low $147.91 Median $162.18 Typical High $316.23 | Professional | None | $147.91 | $162.18 | $316.23 |
Midlands Setting Facility Modifier None Typical Low $114.82 Median $151.36 Typical High $234.42 | Facility | None | $114.82 | $151.36 | $234.42 |
Midlands Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $263.03 | Professional | None | $134.90 | $134.90 | $263.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $93.33 Median $169.82 Typical High $302.00 | Professional | None | $93.33 | $169.82 | $302.00 |
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 $81.28 Median $177.83 Typical High $416.87 | Professional | None | $81.28 | $177.83 | $416.87 |
Wellmark Setting Professional Modifier None Typical Low $134.90 Median $158.49 Typical High $467.74 | Professional | None | $134.90 | $158.49 | $467.74 |
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 $26.92 Median $53.70 Typical High $81.28 | Professional | 52 · Reduced service | $26.92 | $53.70 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $21.38 Typical High $32.36 | Professional | 53 · Discontinued | $10.96 | $21.38 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $81.28 Typical High $120.23 | Professional | 54 · Surgery only | $40.74 | $81.28 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $16.22 Typical High $23.99 | Professional | 55 · Aftercare only | $8.13 | $16.22 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.37 Median $10.72 Typical High $16.22 | Professional | 56 · Pre-op care only | $5.37 | $10.72 | $16.22 |
Where South Dakota sits
The same service costs 3.7 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
$186
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.