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 $74.13 Median $144.54 Typical High $4,365.16 | Facility | None | $74.13 | $144.54 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $117.49 Typical High $169.82 | Professional | None | $63.10 | $117.49 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $102.33 Median $144.54 Typical High $281.84 | Facility | None | $102.33 | $144.54 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $251.19 Typical High $446.68 | Professional | None | $169.82 | $251.19 | $446.68 |
Medica Setting Facility Modifier None Typical Low $107.15 Median $223.87 Typical High $549.54 | Facility | None | $107.15 | $223.87 | $549.54 |
Medica Setting Professional Modifier None Typical Low $138.04 Median $389.05 Typical High $1,148.15 | Professional | None | $138.04 | $389.05 | $1,148.15 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $302.00 | Professional | None | $169.82 | $169.82 | $302.00 |
Midlands Setting Facility Modifier None Typical Low $102.33 Median $134.90 Typical High $169.82 | Facility | None | $102.33 | $134.90 | $169.82 |
Midlands Setting Professional Modifier None Typical Low $154.88 Median $154.88 Typical High $295.12 | Professional | None | $154.88 | $154.88 | $295.12 |
Sanford Health Plan Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $275.42 | Professional | None | $104.71 | $165.96 | $275.42 |
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 $89.13 Median $208.93 Typical High $407.38 | Professional | None | $89.13 | $208.93 | $407.38 |
Wellmark Setting Professional Modifier None Typical Low $138.04 Median $165.96 Typical High $371.54 | Professional | None | $138.04 | $165.96 | $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 $31.62 Median $37.15 Typical High $70.79 | Professional | 52 · Reduced service | $31.62 | $37.15 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.79 Typical High $28.84 | Professional | 53 · Discontinued | $12.59 | $14.79 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $56.23 Typical High $107.15 | Professional | 54 · Surgery only | $47.86 | $56.23 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $11.22 Typical High $21.38 | Professional | 55 · Aftercare only | $9.55 | $11.22 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.41 Typical High $14.13 | Professional | 56 · Pre-op care only | $6.31 | $7.41 | $14.13 |
Where South Dakota sits
The same service costs 3.3 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
$200
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.