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 $380.19 Median $1,819.70 Typical High $4,365.16 | Facility | None | $380.19 | $1,819.70 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $331.13 Median $1,023.29 Typical High $2,290.87 | Professional | None | $331.13 | $1,023.29 | $2,290.87 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $2,398.83 Typical High $3,019.95 | Facility | None | $1,174.90 | $2,398.83 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,258.93 Typical High $4,786.30 | Professional | None | $870.96 | $1,258.93 | $4,786.30 |
Medica Setting Facility Modifier None Typical Low $562.34 Median $1,698.24 Typical High $2,511.89 | Facility | None | $562.34 | $1,698.24 | $2,511.89 |
Medica Setting Professional Modifier None Typical Low $1,584.89 Median $4,897.79 Typical High $5,888.44 | Professional | None | $1,584.89 | $4,897.79 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $4,168.69 | Professional | None | $870.96 | $870.96 | $4,168.69 |
Midlands Setting Facility Modifier None Typical Low $1,174.90 Median $2,187.76 Typical High $2,754.23 | Facility | None | $1,174.90 | $2,187.76 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $3,715.35 | Professional | None | $776.25 | $776.25 | $3,715.35 |
Sanford Health Plan Setting Professional Modifier None Typical Low $562.34 Median $1,621.81 Typical High $3,090.30 | Professional | None | $562.34 | $1,621.81 | $3,090.30 |
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 $446.68 Median $1,047.13 Typical High $5,128.61 | Professional | None | $446.68 | $1,047.13 | $5,128.61 |
Wellmark Setting Professional Modifier None Typical Low $707.95 Median $870.96 Typical High $8,317.64 | Professional | None | $707.95 | $870.96 | $8,317.64 |
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 $165.96 Median $190.55 Typical High $831.76 | Professional | 52 · Reduced service | $165.96 | $190.55 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $75.86 Typical High $331.13 | Professional | 53 · Discontinued | $66.07 | $75.86 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $245.47 Median $288.40 Typical High $1,258.93 | Professional | 54 · Surgery only | $245.47 | $288.40 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $50.12 Median $57.54 Typical High $251.19 | Professional | 55 · Aftercare only | $50.12 | $57.54 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.02 Typical High $165.96 | Professional | 56 · Pre-op care only | $33.11 | $38.02 | $165.96 |
Where South Dakota sits
The same service costs 3.6 times more in Iowa than in Nebraska. 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· 24th of 51
$1,698
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.