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 $109.65 Typical High $4,365.16 | Facility | None | $70.79 | $109.65 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $70.79 Typical High $109.65 | Professional | None | $60.26 | $70.79 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $346.74 | Professional | None | $144.54 | $204.17 | $346.74 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $177.83 Typical High $331.13 | Facility | None | $93.33 | $177.83 | $331.13 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $234.42 Typical High $3,548.13 | Professional | None | $109.65 | $234.42 | $3,548.13 |
Midlands Setting Professional Modifier None Typical Low $165.96 Median $177.83 Typical High $234.42 | Professional | None | $165.96 | $177.83 | $234.42 |
Midlands Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $239.88 | Professional | None | $141.25 | $141.25 | $239.88 |
Sanford Health Plan Setting Professional Modifier None Typical Low $85.11 Median $141.25 Typical High $218.78 | Professional | None | $85.11 | $141.25 | $218.78 |
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 $95.50 Median $190.55 Typical High $302.00 | Professional | None | $95.50 | $190.55 | $302.00 |
Wellmark Setting Professional Modifier None Typical Low $123.03 Median $151.36 Typical High $288.40 | Professional | None | $123.03 | $151.36 | $288.40 |
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 $30.20 Median $35.48 Typical High $54.95 | Professional | 52 · Reduced service | $30.20 | $35.48 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $14.13 Typical High $21.88 | Professional | 53 · Discontinued | $12.02 | $14.13 | $21.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $53.70 Typical High $81.28 | Professional | 54 · Surgery only | $44.67 | $53.70 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $10.72 Typical High $16.60 | Professional | 55 · Aftercare only | $8.91 | $10.72 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $7.08 Typical High $10.96 | Professional | 56 · Pre-op care only | $6.03 | $7.08 | $10.96 |
Where South Dakota sits
The same service costs 3.2 times more in Alaska than in Florida. 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· 7th of 51
$170
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.