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 $141.25 Median $177.83 Typical High $4,365.16 | Facility | None | $141.25 | $177.83 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $169.82 | Professional | None | $117.49 | $141.25 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $95.50 Median $123.03 Typical High $331.13 | Facility | None | $95.50 | $123.03 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $407.38 Typical High $524.81 | Professional | None | $295.12 | $407.38 | $524.81 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $257.04 Typical High $549.54 | Facility | None | $186.21 | $257.04 | $549.54 |
Medica Setting Professional Modifier None Typical Low $177.83 Median $467.74 Typical High $1,318.26 | Professional | None | $177.83 | $467.74 | $1,318.26 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $407.38 | Professional | None | $331.13 | $331.13 | $407.38 |
Midlands Setting Facility Modifier None Typical Low $95.50 Median $117.49 Typical High $144.54 | Facility | None | $95.50 | $117.49 | $144.54 |
Midlands Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $363.08 | Professional | None | $295.12 | $295.12 | $363.08 |
Sanford Health Plan Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $346.74 | Professional | None | $194.98 | $263.03 | $346.74 |
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 $154.88 Median $380.19 Typical High $489.78 | Professional | None | $154.88 | $380.19 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $257.04 Median $309.03 Typical High $457.09 | Professional | None | $257.04 | $309.03 | $457.09 |
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 $58.88 Median $70.79 Typical High $83.18 | Professional | 52 · Reduced service | $58.88 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $28.18 Typical High $33.88 | Professional | 53 · Discontinued | $23.44 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $107.15 Typical High $125.89 | Professional | 54 · Surgery only | $89.13 | $107.15 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $21.38 Typical High $25.12 | Professional | 55 · Aftercare only | $17.78 | $21.38 | $25.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $14.13 Typical High $16.98 | Professional | 56 · Pre-op care only | $11.75 | $14.13 | $16.98 |
Where South Dakota sits
The same service costs 3.4 times more in Alaska than in Pennsylvania. 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
$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.