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 $29.51 Median $38.02 Typical High $4,365.16 | Facility | None | $29.51 | $38.02 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $23.99 Median $32.36 Typical High $44.67 | Professional | None | $23.99 | $32.36 | $44.67 |
Cigna Setting Facility Modifier None Typical Low $19.95 Median $53.70 Typical High $67.61 | Facility | None | $19.95 | $53.70 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $81.28 Typical High $107.15 | Professional | None | $61.66 | $81.28 | $107.15 |
Medica Setting Facility Modifier None Typical Low $40.74 Median $53.70 Typical High $151.36 | Facility | None | $40.74 | $53.70 | $151.36 |
Medica Setting Professional Modifier None Typical Low $38.90 Median $102.33 Typical High $501.19 | Professional | None | $38.90 | $102.33 | $501.19 |
Midlands Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $87.10 | Professional | None | $67.61 | $67.61 | $87.10 |
Midlands Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
Midlands Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $77.62 | Professional | None | $61.66 | $61.66 | $77.62 |
Sanford Health Plan Setting Professional Modifier None Typical Low $41.69 Median $56.23 Typical High $72.44 | Professional | None | $41.69 | $56.23 | $72.44 |
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 $33.88 Median $77.62 Typical High $107.15 | Professional | None | $33.88 | $77.62 | $107.15 |
Wellmark Setting Professional Modifier None Typical Low $51.29 Median $61.66 Typical High $95.50 | Professional | None | $51.29 | $61.66 | $95.50 |
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 $12.02 Median $14.79 Typical High $17.38 | Professional | 52 · Reduced service | $12.02 | $14.79 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $5.89 Typical High $6.92 | Professional | 53 · Discontinued | $4.79 | $5.89 | $6.92 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $18.20 Median $21.88 Typical High $26.30 | Professional | 54 · Surgery only | $18.20 | $21.88 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.63 Median $4.37 Typical High $5.25 | Professional | 55 · Aftercare only | $3.63 | $4.37 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.40 Median $2.95 Typical High $3.47 | Professional | 56 · Pre-op care only | $2.40 | $2.95 | $3.47 |
Where South Dakota sits
The same service costs 3.3 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
$64.57
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.