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 $123.03 Median $199.53 Typical High $4,365.16 | Facility | None | $123.03 | $199.53 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $173.78 Typical High $229.09 | Professional | None | $102.33 | $173.78 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $812.83 Typical High $1,047.13 | Facility | None | $302.00 | $812.83 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $354.81 Typical High $602.56 | Professional | None | $281.84 | $354.81 | $602.56 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $295.12 Typical High $1,202.26 | Facility | None | $158.49 | $295.12 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $537.03 Typical High $3,548.13 | Professional | None | $194.98 | $537.03 | $3,548.13 |
Midlands Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $446.68 | Professional | None | $288.40 | $288.40 | $446.68 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $870.96 Typical High $1,047.13 | Facility | None | $645.65 | $870.96 | $1,047.13 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $407.38 | Professional | None | $251.19 | $251.19 | $407.38 |
Sanford Health Plan Setting Professional Modifier None Typical Low $165.96 Median $263.03 Typical High $389.05 | Professional | None | $165.96 | $263.03 | $389.05 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $151.36 Median $338.84 Typical High $562.34 | Professional | None | $151.36 | $338.84 | $562.34 |
Wellmark Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $501.19 | Professional | None | $208.93 | $257.04 | $501.19 |
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 $51.29 Median $61.66 Typical High $95.50 | Professional | 52 · Reduced service | $51.29 | $61.66 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $24.55 Typical High $38.90 | Professional | 53 · Discontinued | $20.42 | $24.55 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $91.20 Typical High $144.54 | Professional | 54 · Surgery only | $77.62 | $91.20 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $18.62 Typical High $28.84 | Professional | 55 · Aftercare only | $15.49 | $18.62 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.30 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.23 | $12.30 | $19.50 |
Where South Dakota sits
The same service costs 4.0 times more in Alaska 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
$324
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.