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 $288.40 Median $389.05 Typical High $4,365.16 | Facility | None | $288.40 | $389.05 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $288.40 Typical High $380.19 | Professional | None | $186.21 | $288.40 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $741.31 Typical High $3,019.95 | Facility | None | $457.09 | $741.31 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $831.76 Typical High $1,202.26 | Professional | None | $660.69 | $831.76 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $537.03 Typical High $758.58 | Facility | None | $407.38 | $537.03 | $758.58 |
Medica Setting Professional Modifier None Typical Low $398.11 Median $870.96 Typical High $4,897.79 | Professional | None | $398.11 | $870.96 | $4,897.79 |
Midlands Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $870.96 | Professional | None | $660.69 | $660.69 | $870.96 |
Midlands Setting Facility Modifier None Typical Low $457.09 Median $954.99 Typical High $3,090.30 | Facility | None | $457.09 | $954.99 | $3,090.30 |
Midlands Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $794.33 | Professional | None | $588.84 | $588.84 | $794.33 |
Sanford Health Plan Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $794.33 | Professional | None | $416.87 | $562.34 | $794.33 |
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 $331.13 Median $758.58 Typical High $1,071.52 | Professional | None | $331.13 | $758.58 | $1,071.52 |
Wellmark Setting Professional Modifier None Typical Low $478.63 Median $588.84 Typical High $977.24 | Professional | None | $478.63 | $588.84 | $977.24 |
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 $120.23 Median $141.25 Typical High $190.55 | Professional | 52 · Reduced service | $120.23 | $141.25 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $57.54 Typical High $75.86 | Professional | 53 · Discontinued | $48.98 | $57.54 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $213.80 Typical High $288.40 | Professional | 54 · Surgery only | $181.97 | $213.80 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $42.66 Typical High $57.54 | Professional | 55 · Aftercare only | $36.31 | $42.66 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $28.84 Typical High $38.02 | Professional | 56 · Pre-op care only | $24.55 | $28.84 | $38.02 |
Where South Dakota sits
The same service costs 3.9 times more in Alaska than in New York. 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
$661
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.