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 $123.03 Median $269.15 Typical High $4,365.16 | Facility | None | $123.03 | $269.15 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $123.03 Typical High $257.04 | Professional | None | $97.72 | $123.03 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $338.84 Typical High $758.58 | Professional | None | $257.04 | $338.84 | $758.58 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $316.23 Typical High $602.56 | Facility | None | $158.49 | $316.23 | $602.56 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $588.84 Typical High $977.24 | Professional | None | $288.40 | $588.84 | $977.24 |
Midlands Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $588.84 | Professional | None | $288.40 | $302.00 | $588.84 |
Midlands Setting Professional Modifier None Typical Low $234.42 Median $239.88 Typical High $512.86 | Professional | None | $234.42 | $239.88 | $512.86 |
Sanford Health Plan Setting Professional Modifier None Typical Low $169.82 Median $316.23 Typical High $467.74 | Professional | None | $169.82 | $316.23 | $467.74 |
United Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
United Setting Professional Modifier None Typical Low $158.49 Median $338.84 Typical High $741.31 | Professional | None | $158.49 | $338.84 | $741.31 |
Wellmark Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $602.56 | Professional | None | $204.17 | $251.19 | $602.56 |
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 $48.98 Median $61.66 Typical High $128.82 | Professional | 52 · Reduced service | $48.98 | $61.66 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $24.55 Typical High $51.29 | Professional | 53 · Discontinued | $19.50 | $24.55 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $91.20 Typical High $194.98 | Professional | 54 · Surgery only | $74.13 | $91.20 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $18.62 Typical High $38.90 | Professional | 55 · Aftercare only | $14.79 | $18.62 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $12.30 Typical High $25.70 | Professional | 56 · Pre-op care only | $9.77 | $12.30 | $25.70 |
Where South Dakota sits
The same service costs 3.4 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· 10th of 51
$339
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.