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 $234.42 Median $234.42 Typical High $4,365.16 | Facility | None | $234.42 | $234.42 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $316.23 | Professional | None | $208.93 | $208.93 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $436.52 | Facility | None | $346.74 | $346.74 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $489.78 Typical High $691.83 | Professional | None | $316.23 | $489.78 | $691.83 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $758.58 Typical High $1,202.26 | Facility | None | $323.59 | $758.58 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $446.68 Typical High $4,365.16 | Professional | None | $234.42 | $446.68 | $4,365.16 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $512.86 | Professional | None | $316.23 | $316.23 | $512.86 |
Midlands Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $489.78 | Professional | None | $489.78 | $489.78 | $489.78 |
United Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $1,202.26 | Facility | None | $758.58 | $758.58 | $1,202.26 |
United Setting Professional Modifier None Typical Low $213.80 Median $446.68 Typical High $630.96 | Professional | None | $213.80 | $446.68 | $630.96 |
Wellmark Setting Professional Modifier None Typical Low $3,890.45 Median $4,466.84 Typical High $4,466.84 | Professional | None | $3,890.45 | $4,466.84 | $4,466.84 |
3 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 54 · Surgery only Typical Low $154.88 Median $154.88 Typical High $173.78 | Professional | 54 · Surgery only | $154.88 | $154.88 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $31.62 Median $31.62 Typical High $35.48 | Professional | 55 · Aftercare only | $31.62 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $20.89 Typical High $23.44 | Professional | 56 · Pre-op care only | $20.89 | $20.89 | $23.44 |
Where South Dakota sits
The same service costs 8.1 times more in New York than in Missouri. 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· 10th of 51
$447
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.