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 $165.96 Median $354.81 Typical High $4,365.16 | Facility | None | $165.96 | $354.81 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $165.96 Typical High $346.74 | Professional | None | $128.82 | $165.96 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $446.68 Typical High $1,000.00 | Professional | None | $346.74 | $446.68 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $186.21 Median $416.87 Typical High $794.33 | Facility | None | $186.21 | $416.87 | $794.33 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $776.25 Typical High $2,570.40 | Professional | None | $363.08 | $776.25 | $2,570.40 |
Midlands Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $776.25 | Professional | None | $398.11 | $398.11 | $776.25 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $724.44 | Professional | None | $316.23 | $346.74 | $724.44 |
Sanford Health Plan Setting Professional Modifier None Typical Low $218.78 Median $407.38 Typical High $616.60 | Professional | None | $218.78 | $407.38 | $616.60 |
United Setting Facility Modifier None Typical Low $812.83 Median $812.83 Typical High $812.83 | Facility | None | $812.83 | $812.83 | $812.83 |
United Setting Professional Modifier None Typical Low $208.93 Median $467.74 Typical High $1,000.00 | Professional | None | $208.93 | $467.74 | $1,000.00 |
Wellmark Setting Professional Modifier None Typical Low $281.84 Median $346.74 Typical High $912.01 | Professional | None | $281.84 | $346.74 | $912.01 |
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 $64.57 Median $83.18 Typical High $169.82 | Professional | 52 · Reduced service | $64.57 | $83.18 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $33.88 Typical High $69.18 | Professional | 53 · Discontinued | $25.70 | $33.88 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $125.89 Typical High $257.04 | Professional | 54 · Surgery only | $97.72 | $125.89 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $25.12 Typical High $51.29 | Professional | 55 · Aftercare only | $19.50 | $25.12 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $16.60 Typical High $34.67 | Professional | 56 · Pre-op care only | $12.88 | $16.60 | $34.67 |
Where South Dakota sits
The same service costs 3.3 times more in Alaska than in Virginia. 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
$457
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.