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 $64.57 Median $95.50 Typical High $4,365.16 | Facility | None | $64.57 | $95.50 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $123.03 | Professional | None | $54.95 | $79.43 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $79.43 Typical High $186.21 | Facility | None | $51.29 | $79.43 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $302.00 | Professional | None | $147.91 | $181.97 | $302.00 |
Medica Setting Facility Modifier None Typical Low $91.20 Median $151.36 Typical High $549.54 | Facility | None | $91.20 | $151.36 | $549.54 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $257.04 Typical High $776.25 | Professional | None | $89.13 | $257.04 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $154.88 Typical High $208.93 | Professional | None | $151.36 | $154.88 | $208.93 |
Midlands Setting Facility Modifier None Typical Low $51.29 Median $67.61 Typical High $95.50 | Facility | None | $51.29 | $67.61 | $95.50 |
Midlands Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $199.53 | Professional | None | $138.04 | $138.04 | $199.53 |
Sanford Health Plan Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $190.55 | Professional | None | $95.50 | $134.90 | $190.55 |
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 $77.62 Median $173.78 Typical High $269.15 | Professional | None | $77.62 | $173.78 | $269.15 |
Wellmark Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $257.04 | Professional | None | $117.49 | $144.54 | $257.04 |
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 $26.92 Median $32.36 Typical High $47.86 | Professional | 52 · Reduced service | $26.92 | $32.36 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.18 Typical High $19.05 | Professional | 53 · Discontinued | $10.96 | $13.18 | $19.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $40.74 Median $48.98 Typical High $72.44 | Professional | 54 · Surgery only | $40.74 | $48.98 | $72.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $9.77 Typical High $14.45 | Professional | 55 · Aftercare only | $8.13 | $9.77 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.46 Typical High $9.55 | Professional | 56 · Pre-op care only | $5.50 | $6.46 | $9.55 |
Where South Dakota sits
The same service costs 3.6 times more in Wisconsin 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
$151
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.