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 $30.90 Median $75.86 Typical High $4,365.16 | Facility | None | $30.90 | $75.86 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $67.61 Typical High $104.71 | Professional | None | $25.12 | $67.61 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $79.43 Typical High $141.25 | Facility | None | $61.66 | $79.43 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $128.82 Typical High $223.87 | Professional | None | $67.61 | $128.82 | $223.87 |
Medica Setting Facility Modifier None Typical Low $42.66 Median $114.82 Typical High $218.78 | Facility | None | $42.66 | $114.82 | $218.78 |
Medica Setting Professional Modifier None Typical Low $79.43 Median $199.53 Typical High $660.69 | Professional | None | $79.43 | $199.53 | $660.69 |
Midlands Setting Professional Modifier None Typical Low $70.79 Median $70.79 Typical High $169.82 | Professional | None | $70.79 | $70.79 | $169.82 |
Midlands Setting Facility Modifier None Typical Low $61.66 Median $79.43 Typical High $91.20 | Facility | None | $61.66 | $79.43 | $91.20 |
Midlands Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $154.88 | Professional | None | $64.57 | $64.57 | $154.88 |
Sanford Health Plan Setting Professional Modifier None Typical Low $47.86 Median $104.71 Typical High $147.91 | Professional | None | $47.86 | $104.71 | $147.91 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $44.67 Median $85.11 Typical High $208.93 | Professional | None | $44.67 | $85.11 | $208.93 |
Wellmark Setting Professional Modifier None Typical Low $52.48 Median $63.10 Typical High $190.55 | Professional | None | $52.48 | $63.10 | $190.55 |
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 $12.59 Median $15.49 Typical High $38.90 | Professional | 52 · Reduced service | $12.59 | $15.49 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $6.17 Typical High $15.49 | Professional | 53 · Discontinued | $5.01 | $6.17 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $19.05 Median $22.91 Typical High $57.54 | Professional | 54 · Surgery only | $19.05 | $22.91 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $4.57 Typical High $11.75 | Professional | 55 · Aftercare only | $3.80 | $4.57 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.09 Typical High $7.76 | Professional | 56 · Pre-op care only | $2.51 | $3.09 | $7.76 |
Where South Dakota sits
The same service costs 3.1 times more in Wisconsin than in Nebraska. 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· 16th of 51
$95.50
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.