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 $85.11 Median $120.23 Typical High $4,365.16 | Facility | None | $85.11 | $120.23 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $70.79 Median $102.33 Typical High $151.36 | Professional | None | $70.79 | $102.33 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $100.00 Typical High $218.78 | Facility | None | $77.62 | $100.00 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $245.47 Typical High $354.81 | Professional | None | $194.98 | $245.47 | $354.81 |
Medica Setting Facility Modifier None Typical Low $114.82 Median $173.78 Typical High $549.54 | Facility | None | $114.82 | $173.78 | $549.54 |
Medica Setting Professional Modifier None Typical Low $128.82 Median $316.23 Typical High $891.25 | Professional | None | $128.82 | $316.23 | $891.25 |
Midlands Setting Professional Modifier None Typical Low $199.53 Median $199.53 Typical High $269.15 | Professional | None | $199.53 | $199.53 | $269.15 |
Midlands Setting Facility Modifier None Typical Low $77.62 Median $97.72 Typical High $120.23 | Facility | None | $77.62 | $97.72 | $120.23 |
Midlands Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $239.88 | Professional | None | $173.78 | $173.78 | $239.88 |
Sanford Health Plan Setting Professional Modifier None Typical Low $114.82 Median $169.82 Typical High $234.42 | Professional | None | $114.82 | $169.82 | $234.42 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $102.33 Median $234.42 Typical High $331.13 | Professional | None | $102.33 | $234.42 | $331.13 |
Wellmark Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $309.03 | Professional | None | $154.88 | $190.55 | $309.03 |
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 $35.48 Median $42.66 Typical High $56.23 | Professional | 52 · Reduced service | $35.48 | $42.66 | $56.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $16.98 Typical High $22.39 | Professional | 53 · Discontinued | $14.13 | $16.98 | $22.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $53.70 Median $63.10 Typical High $85.11 | Professional | 54 · Surgery only | $53.70 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $12.59 Typical High $16.98 | Professional | 55 · Aftercare only | $10.72 | $12.59 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.51 Typical High $11.22 | Professional | 56 · Pre-op care only | $7.08 | $8.51 | $11.22 |
Where South Dakota sits
The same service costs 3.2 times more in Wisconsin than in Texas. 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· 6th of 51
$200
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.