How much rates vary
Facilitymedian $759 · 10th to 90th $468 to $2,291Professionalmedian $794 · 10th to 90th $417 to $1,148
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 $338.84 Median $416.87 Typical High $4,365.16 | Facility | None | $338.84 | $416.87 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $338.84 Typical High $416.87 | Professional | None | $288.40 | $338.84 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $645.65 Typical High $6,456.54 | Facility | None | $467.74 | $645.65 | $6,456.54 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $954.99 Typical High $1,202.26 | Professional | None | $707.95 | $954.99 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $478.63 Median $602.56 Typical High $1,202.26 | Facility | None | $478.63 | $602.56 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $1,096.48 Typical High $5,888.44 | Professional | None | $446.68 | $1,096.48 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | None | $794.33 | $794.33 | $954.99 |
Midlands Setting Facility Modifier None Typical Low $467.74 Median $645.65 Typical High $6,760.83 | Facility | None | $467.74 | $645.65 | $6,760.83 |
Midlands Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $851.14 | Professional | None | $707.95 | $707.95 | $851.14 |
Sanford Health Plan Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $812.83 | Professional | None | $489.78 | $660.69 | $812.83 |
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 $371.54 Median $912.01 Typical High $1,148.15 | Professional | None | $371.54 | $912.01 | $1,148.15 |
Wellmark Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $1,047.13 | Professional | None | $602.56 | $741.31 | $1,047.13 |
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 $144.54 Median $169.82 Typical High $208.93 | Professional | 52 · Reduced service | $144.54 | $169.82 | $208.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $67.61 Typical High $83.18 | Professional | 53 · Discontinued | $57.54 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $213.80 Median $257.04 Typical High $309.03 | Professional | 54 · Surgery only | $213.80 | $257.04 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $51.29 Typical High $61.66 | Professional | 55 · Aftercare only | $42.66 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $33.88 Typical High $41.69 | Professional | 56 · Pre-op care only | $28.84 | $33.88 | $41.69 |
Where South Dakota sits
The same service costs 9.3 times more in Wyoming than in Delaware. 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.
Physician feeFacility fee
WY $10,585DE $1,135
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.