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 $40.74 Median $70.79 Typical High $4,365.16 | Facility | None | $40.74 | $70.79 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $66.07 Typical High $112.20 | Professional | None | $34.67 | $66.07 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $52.48 Median $112.20 Typical High $138.04 | Facility | None | $52.48 | $112.20 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $114.82 Typical High $218.78 | Professional | None | $91.20 | $114.82 | $218.78 |
Medica Setting Facility Modifier None Typical Low $57.54 Median $112.20 Typical High $181.97 | Facility | None | $57.54 | $112.20 | $181.97 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $186.21 Typical High $645.65 | Professional | None | $75.86 | $186.21 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $158.49 | Professional | None | $95.50 | $95.50 | $158.49 |
Midlands Setting Facility Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Facility | None | $52.48 | $52.48 | $52.48 |
Midlands Setting Professional Modifier None Typical Low $83.18 Median $83.18 Typical High $141.25 | Professional | None | $83.18 | $83.18 | $141.25 |
Sanford Health Plan Setting Professional Modifier None Typical Low $56.23 Median $93.33 Typical High $138.04 | Professional | None | $56.23 | $93.33 | $138.04 |
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 $47.86 Median $112.20 Typical High $194.98 | Professional | None | $47.86 | $112.20 | $194.98 |
Wellmark Setting Professional Modifier None Typical Low $72.44 Median $89.13 Typical High $190.55 | Professional | None | $72.44 | $89.13 | $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 $16.98 Median $20.42 Typical High $38.02 | Professional | 52 · Reduced service | $16.98 | $20.42 | $38.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $8.13 Typical High $15.14 | Professional | 53 · Discontinued | $6.92 | $8.13 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $30.20 Typical High $57.54 | Professional | 54 · Surgery only | $25.70 | $30.20 | $57.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $6.03 Typical High $11.48 | Professional | 55 · Aftercare only | $5.13 | $6.03 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $4.07 Typical High $7.59 | Professional | 56 · Pre-op care only | $3.47 | $4.07 | $7.59 |
Where South Dakota sits
The same service costs 3.4 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· 8th of 51
$112
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.