How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $70.79 Median $398.11 Typical High $4,365.16 | Facility | None | $70.79 | $398.11 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $102.33 Typical High $407.38 | Professional | None | $58.88 | $102.33 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $245.47 Typical High $1,230.27 | Professional | None | $147.91 | $245.47 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $446.68 Typical High $954.99 | Facility | None | $93.33 | $446.68 | $954.99 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $794.33 Typical High $1,548.82 | Professional | None | $316.23 | $794.33 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $794.33 | Professional | None | $169.82 | $177.83 | $794.33 |
Midlands Setting Professional Modifier None Typical Low $141.25 Median $147.91 Typical High $812.83 | Professional | None | $141.25 | $147.91 | $812.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $100.00 Median $407.38 Typical High $741.31 | Professional | None | $100.00 | $407.38 | $741.31 |
United Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,162.28 | Facility | None | $3,162.28 | $3,162.28 | $3,162.28 |
United Setting Professional Modifier None Typical Low $100.00 Median $204.17 Typical High $1,096.48 | Professional | None | $100.00 | $204.17 | $1,096.48 |
Wellmark Setting Professional Modifier None Typical Low $138.04 Median $158.49 Typical High $1,023.29 | Professional | None | $138.04 | $158.49 | $1,023.29 |
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 $29.51 Median $35.48 Typical High $199.53 | Professional | 52 · Reduced service | $29.51 | $35.48 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $14.45 Typical High $79.43 | Professional | 53 · Discontinued | $11.75 | $14.45 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $43.65 Median $53.70 Typical High $295.12 | Professional | 54 · Surgery only | $43.65 | $53.70 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $10.72 Typical High $58.88 | Professional | 55 · Aftercare only | $8.71 | $10.72 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $7.08 Typical High $39.81 | Professional | 56 · Pre-op care only | $5.89 | $7.08 | $39.81 |
Where South Dakota sits
The same service costs 5.6 times more in Wisconsin than in Maryland. 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· 14th of 51
$407
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.