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 $46.77 Median $67.61 Typical High $4,365.16 | Facility | None | $46.77 | $67.61 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $38.02 Median $63.10 Typical High $95.50 | Professional | None | $38.02 | $63.10 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $48.98 Median $60.26 Typical High $134.90 | Facility | None | $48.98 | $60.26 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $128.82 Typical High $213.80 | Professional | None | $102.33 | $128.82 | $213.80 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $107.15 Typical High $199.53 | Facility | None | $64.57 | $107.15 | $199.53 |
Medica Setting Professional Modifier None Typical Low $75.86 Median $181.97 Typical High $549.54 | Professional | None | $75.86 | $181.97 | $549.54 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $109.65 Typical High $144.54 | Professional | None | $107.15 | $109.65 | $144.54 |
Midlands Setting Facility Modifier None Typical Low $43.65 Median $52.48 Typical High $69.18 | Facility | None | $43.65 | $52.48 | $69.18 |
Midlands Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $131.83 | Professional | None | $97.72 | $97.72 | $131.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $67.61 Median $97.72 Typical High $144.54 | Professional | None | $67.61 | $97.72 | $144.54 |
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 $54.95 Median $128.82 Typical High $190.55 | Professional | None | $54.95 | $128.82 | $190.55 |
Wellmark Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $173.78 | Professional | None | $81.28 | $97.72 | $173.78 |
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 $19.05 Median $22.91 Typical High $34.67 | Professional | 52 · Reduced service | $19.05 | $22.91 | $34.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $9.33 Typical High $13.80 | Professional | 53 · Discontinued | $7.59 | $9.33 | $13.80 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $34.67 Typical High $51.29 | Professional | 54 · Surgery only | $28.84 | $34.67 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.92 Typical High $10.23 | Professional | 55 · Aftercare only | $5.75 | $6.92 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.68 Typical High $6.92 | Professional | 56 · Pre-op care only | $3.80 | $4.68 | $6.92 |
Where South Dakota sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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
$107
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.