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 $91.20 Median $120.23 Typical High $4,365.16 | Facility | None | $91.20 | $120.23 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $75.86 Median $109.65 Typical High $158.49 | Professional | None | $75.86 | $109.65 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $229.09 | Facility | None | $63.10 | $93.33 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $363.08 | Professional | None | $208.93 | $257.04 | $363.08 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $154.88 Typical High $223.87 | Facility | None | $125.89 | $154.88 | $223.87 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $316.23 Typical High $933.25 | Professional | None | $109.65 | $316.23 | $933.25 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $257.04 | Professional | None | $208.93 | $208.93 | $257.04 |
Midlands Setting Facility Modifier None Typical Low $63.10 Median $83.18 Typical High $109.65 | Facility | None | $63.10 | $83.18 | $109.65 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $251.19 | Professional | None | $190.55 | $190.55 | $251.19 |
Sanford Health Plan Setting Professional Modifier None Typical Low $123.03 Median $177.83 Typical High $234.42 | Professional | None | $123.03 | $177.83 | $234.42 |
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 $104.71 Median $239.88 Typical High $331.13 | Professional | None | $104.71 | $239.88 | $331.13 |
Wellmark Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $309.03 | Professional | None | $165.96 | $199.53 | $309.03 |
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 $38.02 Median $45.71 Typical High $58.88 | Professional | 52 · Reduced service | $38.02 | $45.71 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.14 Median $18.20 Typical High $23.44 | Professional | 53 · Discontinued | $15.14 | $18.20 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $57.54 Median $67.61 Typical High $89.13 | Professional | 54 · Surgery only | $57.54 | $67.61 | $89.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.49 Typical High $17.78 | Professional | 55 · Aftercare only | $11.48 | $13.49 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.59 Median $9.12 Typical High $11.75 | Professional | 56 · Pre-op care only | $7.59 | $9.12 | $11.75 |
Where South Dakota sits
The same service costs 3.7 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· 6th of 51
$209
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.