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 $85.11 Typical High $4,365.16 | Facility | None | $57.54 | $85.11 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $72.44 Typical High $147.91 | Professional | None | $45.71 | $72.44 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $114.82 Typical High $158.49 | Facility | None | $69.18 | $114.82 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $158.49 Typical High $223.87 | Professional | None | $112.20 | $158.49 | $223.87 |
Medica Setting Facility Modifier None Typical Low $77.62 Median $123.03 Typical High $549.54 | Facility | None | $77.62 | $123.03 | $549.54 |
Medica Setting Professional Modifier None Typical Low $117.49 Median $229.09 Typical High $1,148.15 | Professional | None | $117.49 | $229.09 | $1,148.15 |
Midlands Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $218.78 | Professional | None | $131.83 | $131.83 | $218.78 |
Midlands Setting Facility Modifier None Typical Low $69.18 Median $81.28 Typical High $158.49 | Facility | None | $69.18 | $81.28 | $158.49 |
Midlands Setting Professional Modifier None Typical Low $117.49 Median $169.82 Typical High $323.59 | Professional | None | $117.49 | $169.82 | $323.59 |
Sanford Health Plan Setting Professional Modifier None Typical Low $85.11 Median $117.49 Typical High $194.98 | Professional | None | $85.11 | $117.49 | $194.98 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $74.13 Median $158.49 Typical High $288.40 | Professional | None | $74.13 | $158.49 | $288.40 |
Wellmark Setting Professional Modifier None Typical Low $100.00 Median $117.49 Typical High $218.78 | Professional | None | $100.00 | $117.49 | $218.78 |
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 $22.91 Median $36.31 Typical High $42.66 | Professional | 52 · Reduced service | $22.91 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $14.45 Typical High $16.98 | Professional | 53 · Discontinued | $9.12 | $14.45 | $16.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $54.95 Typical High $64.57 | Professional | 54 · Surgery only | $33.88 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.92 Median $10.96 Typical High $12.88 | Professional | 55 · Aftercare only | $6.92 | $10.96 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $7.24 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.57 | $7.24 | $8.51 |
Where South Dakota sits
The same service costs 3.2 times more in Alaska than in Kentucky. 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
$148
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.