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 $70.79 Median $501.19 Typical High $2,290.87 | Facility | None | $70.79 | $501.19 | $2,290.87 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $72.44 Typical High $117.49 | Professional | None | $41.69 | $72.44 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $56.23 Median $79.43 Typical High $134.90 | Facility | None | $56.23 | $79.43 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $102.33 Median $144.54 Typical High $213.80 | Professional | None | $102.33 | $144.54 | $213.80 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $104.71 Typical High $223.87 | Facility | None | $70.79 | $104.71 | $223.87 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $186.21 Typical High $1,148.15 | Professional | None | $93.33 | $186.21 | $1,148.15 |
Midlands Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $186.21 | Professional | None | $120.23 | $120.23 | $186.21 |
Midlands Setting Facility Modifier None Typical Low $53.70 Median $66.07 Typical High $104.71 | Facility | None | $53.70 | $66.07 | $104.71 |
Midlands Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $223.87 | Professional | None | $112.20 | $138.04 | $223.87 |
Sanford Health Plan Setting Professional Modifier None Typical Low $75.86 Median $114.82 Typical High $154.88 | Professional | None | $75.86 | $114.82 | $154.88 |
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 $64.57 Median $138.04 Typical High $194.98 | Professional | None | $64.57 | $138.04 | $194.98 |
Wellmark Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $194.98 | Professional | None | $95.50 | $112.20 | $194.98 |
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 $20.89 Median $30.90 Typical High $36.31 | Professional | 52 · Reduced service | $20.89 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $12.30 Typical High $14.45 | Professional | 53 · Discontinued | $8.32 | $12.30 | $14.45 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $46.77 Typical High $54.95 | Professional | 54 · Surgery only | $31.62 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $9.33 Typical High $10.96 | Professional | 55 · Aftercare only | $6.31 | $9.33 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $6.17 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.17 | $6.17 | $7.24 |
Where South Dakota sits
The same service costs 3.2 times more in Alaska than in Texas. 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· 6th of 51
$123
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.