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 $52.48 Median $91.20 Typical High $4,365.16 | Facility | None | $52.48 | $91.20 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $42.66 Median $67.61 Typical High $125.89 | Professional | None | $42.66 | $67.61 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $204.17 | Facility | None | $162.18 | $162.18 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $323.59 | Professional | None | $114.82 | $147.91 | $323.59 |
Medica Setting Facility Modifier None Typical Low $72.44 Median $138.04 Typical High $223.87 | Facility | None | $72.44 | $138.04 | $223.87 |
Medica Setting Professional Modifier None Typical Low $79.43 Median $245.47 Typical High $812.83 | Professional | None | $79.43 | $245.47 | $812.83 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $181.97 | Professional | None | $123.03 | $123.03 | $181.97 |
Midlands Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $144.54 | Professional | None | $107.15 | $107.15 | $144.54 |
Sanford Health Plan Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $199.53 | Professional | None | $77.62 | $117.49 | $199.53 |
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 $63.10 Median $144.54 Typical High $257.04 | Professional | None | $63.10 | $144.54 | $257.04 |
Wellmark Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $257.04 | Professional | None | $87.10 | $107.15 | $257.04 |
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 $21.38 Median $26.30 Typical High $51.29 | Professional | 52 · Reduced service | $21.38 | $26.30 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.51 Median $10.47 Typical High $20.89 | Professional | 53 · Discontinued | $8.51 | $10.47 | $20.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $38.90 Typical High $77.62 | Professional | 54 · Surgery only | $31.62 | $38.90 | $77.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $7.76 Typical High $15.49 | Professional | 55 · Aftercare only | $6.46 | $7.76 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.27 Median $5.25 Typical High $10.47 | Professional | 56 · Pre-op care only | $4.27 | $5.25 | $10.47 |
Where South Dakota sits
The same service costs 3.2 times more in Alaska than in New York. 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· 12th of 51
$126
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.