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 $114.82 Median $169.82 Typical High $4,365.16 | Facility | None | $114.82 | $169.82 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $144.54 Typical High $208.93 | Professional | None | $93.33 | $144.54 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $162.18 Typical High $323.59 | Facility | None | $141.25 | $162.18 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $436.52 | Professional | None | $223.87 | $323.59 | $436.52 |
Medica Setting Facility Modifier None Typical Low $158.49 Median $251.19 Typical High $549.54 | Facility | None | $158.49 | $251.19 | $549.54 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $398.11 Typical High $1,318.26 | Professional | None | $173.78 | $398.11 | $1,318.26 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $380.19 | Professional | None | $263.03 | $263.03 | $380.19 |
Midlands Setting Facility Modifier None Typical Low $141.25 Median $151.36 Typical High $190.55 | Facility | None | $141.25 | $151.36 | $190.55 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $257.04 Typical High $354.81 | Professional | None | $245.47 | $257.04 | $354.81 |
Sanford Health Plan Setting Professional Modifier None Typical Low $173.78 Median $239.88 Typical High $331.13 | Professional | None | $173.78 | $239.88 | $331.13 |
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 $138.04 Median $302.00 Typical High $467.74 | Professional | None | $138.04 | $302.00 | $467.74 |
Wellmark Setting Professional Modifier None Typical Low $213.80 Median $251.19 Typical High $467.74 | Professional | None | $213.80 | $251.19 | $467.74 |
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 $46.77 Median $74.13 Typical High $87.10 | Professional | 52 · Reduced service | $46.77 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $29.51 Typical High $35.48 | Professional | 53 · Discontinued | $18.62 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $112.20 Typical High $131.83 | Professional | 54 · Surgery only | $70.79 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $22.39 Typical High $26.30 | Professional | 55 · Aftercare only | $14.13 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $14.79 Typical High $17.38 | Professional | 56 · Pre-op care only | $9.33 | $14.79 | $17.38 |
Where South Dakota sits
The same service costs 3.3 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· 8th of 51
$263
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.