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 $52.48 Median $95.50 Typical High $4,365.16 | Facility | None | $52.48 | $95.50 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $85.11 Typical High $138.04 | Professional | None | $43.65 | $85.11 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $93.33 Typical High $181.97 | Facility | None | $70.79 | $93.33 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $288.40 | Professional | None | $120.23 | $165.96 | $288.40 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $125.89 Typical High $223.87 | Facility | None | $74.13 | $125.89 | $223.87 |
Medica Setting Professional Modifier None Typical Low $100.00 Median $257.04 Typical High $724.44 | Professional | None | $100.00 | $257.04 | $724.44 |
Midlands Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $213.80 | Professional | None | $120.23 | $120.23 | $213.80 |
Midlands Setting Facility Modifier None Typical Low $70.79 Median $91.20 Typical High $109.65 | Facility | None | $70.79 | $91.20 | $109.65 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $186.21 | Professional | None | $107.15 | $107.15 | $186.21 |
Sanford Health Plan Setting Professional Modifier None Typical Low $83.18 Median $138.04 Typical High $181.97 | Professional | None | $83.18 | $138.04 | $181.97 |
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 $67.61 Median $144.54 Typical High $269.15 | Professional | None | $67.61 | $144.54 | $269.15 |
Wellmark Setting Professional Modifier None Typical Low $93.33 Median $114.82 Typical High $245.47 | Professional | None | $93.33 | $114.82 | $245.47 |
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 $21.88 Median $26.30 Typical High $50.12 | Professional | 52 · Reduced service | $21.88 | $26.30 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.91 Median $10.47 Typical High $19.95 | Professional | 53 · Discontinued | $8.91 | $10.47 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $38.90 Typical High $74.13 | Professional | 54 · Surgery only | $33.11 | $38.90 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.76 Typical High $14.79 | Professional | 55 · Aftercare only | $6.61 | $7.76 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.25 Typical High $10.00 | Professional | 56 · Pre-op care only | $4.37 | $5.25 | $10.00 |
Where South Dakota sits
The same service costs 2.8 times more in Wisconsin than in Kentucky. 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· 9th of 51
$138
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.