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 $57.54 Median $89.13 Typical High $4,365.16 | Facility | None | $57.54 | $89.13 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $77.62 Typical High $104.71 | Professional | None | $47.86 | $77.62 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $70.79 Typical High $165.96 | Facility | None | $53.70 | $70.79 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $158.49 Typical High $263.03 | Professional | None | $125.89 | $158.49 | $263.03 |
Medica Setting Facility Modifier None Typical Low $79.43 Median $125.89 Typical High $223.87 | Facility | None | $79.43 | $125.89 | $223.87 |
Medica Setting Professional Modifier None Typical Low $89.13 Median $234.42 Typical High $676.08 | Professional | None | $89.13 | $234.42 | $676.08 |
Midlands Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $199.53 | Professional | None | $134.90 | $134.90 | $199.53 |
Midlands Setting Facility Modifier None Typical Low $53.70 Median $69.18 Typical High $81.28 | Facility | None | $53.70 | $69.18 | $81.28 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $181.97 | Professional | None | $123.03 | $123.03 | $181.97 |
Sanford Health Plan Setting Professional Modifier None Typical Low $91.20 Median $123.03 Typical High $173.78 | Professional | None | $91.20 | $123.03 | $173.78 |
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 $69.18 Median $158.49 Typical High $245.47 | Professional | None | $69.18 | $158.49 | $245.47 |
Wellmark Setting Professional Modifier None Typical Low $100.00 Median $123.03 Typical High $229.09 | Professional | None | $100.00 | $123.03 | $229.09 |
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 $23.99 Median $28.84 Typical High $42.66 | Professional | 52 · Reduced service | $23.99 | $28.84 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $11.48 Typical High $16.98 | Professional | 53 · Discontinued | $9.55 | $11.48 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $43.65 Typical High $63.10 | Professional | 54 · Surgery only | $35.48 | $43.65 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $8.71 Typical High $12.59 | Professional | 55 · Aftercare only | $7.08 | $8.71 | $12.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $5.75 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.79 | $5.75 | $8.51 |
Where South Dakota sits
The same service costs 3.1 times more in Wisconsin than in Washington, DC. 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
$135
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.