How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $158.49 Median $338.84 Typical High $4,365.16 | Facility | None | $158.49 | $338.84 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $158.49 Typical High $309.03 | Professional | None | $117.49 | $158.49 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $912.01 | Professional | None | $331.13 | $512.86 | $912.01 |
Medica Setting Facility Modifier None Typical Low $173.78 Median $380.19 Typical High $724.44 | Facility | None | $173.78 | $380.19 | $724.44 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $741.31 Typical High $2,344.23 | Professional | None | $363.08 | $741.31 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $741.31 | Professional | None | $380.19 | $380.19 | $741.31 |
Midlands Setting Professional Modifier None Typical Low $288.40 Median $331.13 Typical High $691.83 | Professional | None | $288.40 | $331.13 | $691.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $204.17 Median $363.08 Typical High $562.34 | Professional | None | $204.17 | $363.08 | $562.34 |
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 $204.17 Median $446.68 Typical High $954.99 | Professional | None | $204.17 | $446.68 | $954.99 |
Wellmark Setting Professional Modifier None Typical Low $269.15 Median $323.59 Typical High $831.76 | Professional | None | $269.15 | $323.59 | $831.76 |
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 $58.88 Median $79.43 Typical High $154.88 | Professional | 52 · Reduced service | $58.88 | $79.43 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $31.62 Typical High $61.66 | Professional | 53 · Discontinued | $23.44 | $31.62 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $120.23 Typical High $229.09 | Professional | 54 · Surgery only | $89.13 | $120.23 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $23.99 Typical High $45.71 | Professional | 55 · Aftercare only | $17.78 | $23.99 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $15.85 Typical High $30.90 | Professional | 56 · Pre-op care only | $11.75 | $15.85 | $30.90 |
Where South Dakota sits
The same service costs 3.5 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· 9th of 51
$437
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.