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 $102.33 Median $144.54 Typical High $4,365.16 | Facility | None | $102.33 | $144.54 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $190.55 | Professional | None | $83.18 | $128.82 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $107.15 Typical High $275.42 | Facility | None | $77.62 | $107.15 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $281.84 Typical High $436.52 | Professional | None | $223.87 | $281.84 | $436.52 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $186.21 Typical High $229.09 | Facility | None | $125.89 | $186.21 | $229.09 |
Medica Setting Professional Modifier None Typical Low $134.90 Median $389.05 Typical High $1,122.02 | Professional | None | $134.90 | $389.05 | $1,122.02 |
Midlands Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $316.23 | Professional | None | $234.42 | $234.42 | $316.23 |
Midlands Setting Facility Modifier None Typical Low $77.62 Median $102.33 Typical High $128.82 | Facility | None | $77.62 | $102.33 | $128.82 |
Midlands Setting Professional Modifier None Typical Low $213.80 Median $213.80 Typical High $302.00 | Professional | None | $213.80 | $213.80 | $302.00 |
Sanford Health Plan Setting Professional Modifier None Typical Low $144.54 Median $199.53 Typical High $281.84 | Professional | None | $144.54 | $199.53 | $281.84 |
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 $120.23 Median $269.15 Typical High $407.38 | Professional | None | $120.23 | $269.15 | $407.38 |
Wellmark Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $371.54 | Professional | None | $177.83 | $218.78 | $371.54 |
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 $41.69 Median $50.12 Typical High $70.79 | Professional | 52 · Reduced service | $41.69 | $50.12 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $20.42 Typical High $28.18 | Professional | 53 · Discontinued | $16.98 | $20.42 | $28.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $75.86 Typical High $104.71 | Professional | 54 · Surgery only | $63.10 | $75.86 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $15.14 Typical High $21.38 | Professional | 55 · Aftercare only | $12.59 | $15.14 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $10.23 Typical High $14.13 | Professional | 56 · Pre-op care only | $8.32 | $10.23 | $14.13 |
Where South Dakota sits
The same service costs 3.2 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· 7th of 51
$224
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.