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 $38.90 Median $169.82 Typical High $4,365.16 | Facility | None | $38.90 | $169.82 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $30.90 Median $50.12 Typical High $173.78 | Professional | None | $30.90 | $50.12 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $295.12 Typical High $524.81 | Professional | None | $81.28 | $295.12 | $524.81 |
Medica Setting Facility Modifier None Typical Low $52.48 Median $213.80 Typical High $426.58 | Facility | None | $52.48 | $213.80 | $426.58 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $346.74 Typical High $1,318.26 | Professional | None | $91.20 | $346.74 | $1,318.26 |
Midlands Setting Professional Modifier None Typical Low $89.13 Median $93.33 Typical High $346.74 | Professional | None | $89.13 | $93.33 | $346.74 |
Midlands Setting Professional Modifier None Typical Low $74.13 Median $79.43 Typical High $354.81 | Professional | None | $74.13 | $79.43 | $354.81 |
Sanford Health Plan Setting Professional Modifier None Typical Low $52.48 Median $177.83 Typical High $316.23 | Professional | None | $52.48 | $177.83 | $316.23 |
United Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
United Setting Professional Modifier None Typical Low $50.12 Median $109.65 Typical High $478.63 | Professional | None | $50.12 | $109.65 | $478.63 |
Wellmark Setting Professional Modifier None Typical Low $70.79 Median $81.28 Typical High $436.52 | Professional | None | $70.79 | $81.28 | $436.52 |
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 $15.49 Median $19.50 Typical High $85.11 | Professional | 52 · Reduced service | $15.49 | $19.50 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $7.76 Typical High $34.67 | Professional | 53 · Discontinued | $6.17 | $7.76 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.91 Median $28.84 Typical High $128.82 | Professional | 54 · Surgery only | $22.91 | $28.84 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.75 Typical High $25.70 | Professional | 55 · Aftercare only | $4.57 | $5.75 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.89 Typical High $16.98 | Professional | 56 · Pre-op care only | $3.09 | $3.89 | $16.98 |
Where South Dakota sits
The same service costs 4.5 times more in Wisconsin than in Michigan. 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
$178
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.