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 $41.69 Median $70.79 Typical High $4,365.16 | Facility | None | $41.69 | $70.79 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $67.61 Typical High $112.20 | Professional | None | $35.48 | $67.61 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $72.44 Typical High $141.25 | Facility | None | $53.70 | $72.44 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $128.82 Typical High $223.87 | Professional | None | $95.50 | $128.82 | $223.87 |
Medica Setting Facility Modifier None Typical Low $60.26 Median $112.20 Typical High $181.97 | Facility | None | $60.26 | $112.20 | $181.97 |
Medica Setting Professional Modifier None Typical Low $77.62 Median $190.55 Typical High $1,380.38 | Professional | None | $77.62 | $190.55 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $158.49 | Professional | None | $97.72 | $97.72 | $158.49 |
Midlands Setting Facility Modifier None Typical Low $53.70 Median $70.79 Typical High $85.11 | Facility | None | $53.70 | $70.79 | $85.11 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $144.54 | Professional | None | $87.10 | $87.10 | $144.54 |
Sanford Health Plan Setting Professional Modifier None Typical Low $67.61 Median $95.50 Typical High $141.25 | Professional | None | $67.61 | $95.50 | $141.25 |
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 $50.12 Median $114.82 Typical High $199.53 | Professional | None | $50.12 | $114.82 | $199.53 |
Wellmark Setting Professional Modifier None Typical Low $74.13 Median $91.20 Typical High $194.98 | Professional | None | $74.13 | $91.20 | $194.98 |
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 $17.78 Median $20.89 Typical High $38.90 | Professional | 52 · Reduced service | $17.78 | $20.89 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $8.32 Typical High $15.49 | Professional | 53 · Discontinued | $7.08 | $8.32 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.92 Median $30.90 Typical High $57.54 | Professional | 54 · Surgery only | $26.92 | $30.90 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $6.31 Typical High $11.48 | Professional | 55 · Aftercare only | $5.37 | $6.31 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $4.17 Typical High $7.76 | Professional | 56 · Pre-op care only | $3.55 | $4.17 | $7.76 |
Where South Dakota sits
The same service costs 3.2 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
$110
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.