How much rates vary
Facilitymedian $1,175 · 10th to 90th $288 to $1,778Professionalmedian $490 · 10th to 90th $288 to $912
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 $199.53 Median $331.13 Typical High $4,365.16 | Facility | None | $199.53 | $331.13 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $338.84 | Professional | None | $169.82 | $281.84 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $1,174.90 Typical High $1,778.28 | Facility | None | $489.78 | $1,174.90 | $1,778.28 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $575.44 Typical High $977.24 | Professional | None | $457.09 | $575.44 | $977.24 |
Medica Setting Facility Modifier None Typical Low $288.40 Median $524.81 Typical High $1,698.24 | Facility | None | $288.40 | $524.81 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $870.96 Typical High $2,630.27 | Professional | None | $302.00 | $870.96 | $2,630.27 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $691.83 | Professional | None | $467.74 | $467.74 | $691.83 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,778.28 | Facility | None | $954.99 | $1,258.93 | $1,778.28 |
Midlands Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $562.34 | Professional | None | $416.87 | $416.87 | $562.34 |
Sanford Health Plan Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $616.60 | Professional | None | $302.00 | $426.58 | $616.60 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,513.56 | $1,513.56 | $1,819.70 |
United Setting Professional Modifier None Typical Low $239.88 Median $562.34 Typical High $912.01 | Professional | None | $239.88 | $562.34 | $912.01 |
Wellmark Setting Professional Modifier None Typical Low $354.81 Median $436.52 Typical High $812.83 | Professional | None | $354.81 | $436.52 | $812.83 |
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 $85.11 Median $100.00 Typical High $169.82 | Professional | 52 · Reduced service | $85.11 | $100.00 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $40.74 Typical High $67.61 | Professional | 53 · Discontinued | $33.88 | $40.74 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $151.36 Typical High $257.04 | Professional | 54 · Surgery only | $125.89 | $151.36 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $30.20 Typical High $51.29 | Professional | 55 · Aftercare only | $25.70 | $30.20 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $19.95 Typical High $33.88 | Professional | 56 · Pre-op care only | $16.98 | $19.95 | $33.88 |
Where South Dakota sits
The same service costs 7.9 times more in Oklahoma than in Montana. 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
OK $5,867MT $745
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.