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 $79.43 Median $131.83 Typical High $4,365.16 | Facility | None | $79.43 | $131.83 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $120.23 Typical High $190.55 | Professional | None | $69.18 | $120.23 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $407.38 Typical High $446.68 | Facility | None | $199.53 | $407.38 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $398.11 | Professional | None | $186.21 | $229.09 | $398.11 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $199.53 Typical High $549.54 | Facility | None | $114.82 | $199.53 | $549.54 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $354.81 Typical High $1,819.70 | Professional | None | $141.25 | $354.81 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $295.12 | Professional | None | $186.21 | $186.21 | $295.12 |
Midlands Setting Facility Modifier None Typical Low $407.38 Median $436.52 Typical High $645.65 | Facility | None | $407.38 | $436.52 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $269.15 | Professional | None | $165.96 | $165.96 | $269.15 |
Sanford Health Plan Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $257.04 | Professional | None | $117.49 | $177.83 | $257.04 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $95.50 Median $218.78 Typical High $371.54 | Professional | None | $95.50 | $218.78 | $371.54 |
Wellmark Setting Professional Modifier None Typical Low $144.54 Median $177.83 Typical High $346.74 | Professional | None | $144.54 | $177.83 | $346.74 |
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 $33.88 Median $39.81 Typical High $69.18 | Professional | 52 · Reduced service | $33.88 | $39.81 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $15.85 Typical High $27.54 | Professional | 53 · Discontinued | $13.80 | $15.85 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $51.29 Median $60.26 Typical High $102.33 | Professional | 54 · Surgery only | $51.29 | $60.26 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $12.02 Typical High $20.42 | Professional | 55 · Aftercare only | $10.23 | $12.02 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $7.94 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.92 | $7.94 | $13.80 |
Where South Dakota sits
The same service costs 3.6 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· 10th of 51
$209
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.