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 $63.10 Median $97.72 Typical High $4,365.16 | Facility | None | $63.10 | $97.72 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $52.48 Median $87.10 Typical High $125.89 | Professional | None | $52.48 | $87.10 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $61.66 Median $81.28 Typical High $181.97 | Facility | None | $61.66 | $81.28 | $181.97 |
Cigna Setting Professional Modifier None Typical Low $141.25 Median $173.78 Typical High $288.40 | Professional | None | $141.25 | $173.78 | $288.40 |
Medica Setting Facility Modifier None Typical Low $89.13 Median $134.90 Typical High $223.87 | Facility | None | $89.13 | $134.90 | $223.87 |
Medica Setting Professional Modifier None Typical Low $109.65 Median $257.04 Typical High $758.58 | Professional | None | $109.65 | $257.04 | $758.58 |
Midlands Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $213.80 | Professional | None | $162.18 | $162.18 | $213.80 |
Midlands Setting Facility Modifier None Typical Low $61.66 Median $70.79 Typical High $83.18 | Facility | None | $61.66 | $70.79 | $83.18 |
Midlands Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $204.17 | Professional | None | $134.90 | $134.90 | $204.17 |
Sanford Health Plan Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $194.98 | Professional | None | $87.10 | $138.04 | $194.98 |
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 $93.33 Median $177.83 Typical High $269.15 | Professional | None | $93.33 | $177.83 | $269.15 |
Wellmark Setting Professional Modifier None Typical Low $109.65 Median $134.90 Typical High $239.88 | Professional | None | $109.65 | $134.90 | $239.88 |
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 $26.30 Median $31.62 Typical High $46.77 | Professional | 52 · Reduced service | $26.30 | $31.62 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.47 Median $12.59 Typical High $18.62 | Professional | 53 · Discontinued | $10.47 | $12.59 | $18.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.90 Median $47.86 Typical High $69.18 | Professional | 54 · Surgery only | $38.90 | $47.86 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.76 Median $9.55 Typical High $14.13 | Professional | 55 · Aftercare only | $7.76 | $9.55 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.25 Median $6.31 Typical High $9.33 | Professional | 56 · Pre-op care only | $5.25 | $6.31 | $9.33 |
Where South Dakota sits
The same service costs 3.0 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
$155
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.