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 $42.66 Median $77.62 Typical High $4,365.16 | Facility | None | $42.66 | $77.62 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $34.67 Median $64.57 Typical High $107.15 | Professional | None | $34.67 | $64.57 | $107.15 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $74.13 Typical High $138.04 | Facility | None | $64.57 | $74.13 | $138.04 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $120.23 Typical High $177.83 | Professional | None | $89.13 | $120.23 | $177.83 |
Medica Setting Facility Modifier None Typical Low $58.88 Median $107.15 Typical High $758.58 | Facility | None | $58.88 | $107.15 | $758.58 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $194.98 Typical High $1,348.96 | Professional | None | $87.10 | $194.98 | $1,348.96 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $177.83 | Professional | None | $104.71 | $104.71 | $177.83 |
Midlands Setting Facility Modifier None Typical Low $64.57 Median $74.13 Typical High $87.10 | Facility | None | $64.57 | $74.13 | $87.10 |
Midlands Setting Professional Modifier None Typical Low $89.13 Median $102.33 Typical High $181.97 | Professional | None | $89.13 | $102.33 | $181.97 |
Sanford Health Plan Setting Professional Modifier None Typical Low $67.61 Median $102.33 Typical High $138.04 | Professional | None | $67.61 | $102.33 | $138.04 |
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 $53.70 Median $112.20 Typical High $213.80 | Professional | None | $53.70 | $112.20 | $213.80 |
Wellmark Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $199.53 | Professional | None | $79.43 | $93.33 | $199.53 |
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 $17.38 Median $31.62 Typical High $37.15 | Professional | 52 · Reduced service | $17.38 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.92 Median $12.88 Typical High $15.14 | Professional | 53 · Discontinued | $6.92 | $12.88 | $15.14 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $25.70 Median $47.86 Typical High $56.23 | Professional | 54 · Surgery only | $25.70 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $9.55 Typical High $11.22 | Professional | 55 · Aftercare only | $5.25 | $9.55 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $6.31 Typical High $7.41 | Professional | 56 · Pre-op care only | $3.47 | $6.31 | $7.41 |
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
$107
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.