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 $79.43 Median $114.82 Typical High $4,365.16 | Facility | None | $79.43 | $114.82 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $100.00 Typical High $141.25 | Professional | None | $64.57 | $100.00 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $173.78 Typical High $213.80 | Facility | None | $173.78 | $173.78 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $295.12 | Professional | None | $158.49 | $218.78 | $295.12 |
Medica Setting Facility Modifier None Typical Low $109.65 Median $141.25 Typical High $223.87 | Facility | None | $109.65 | $141.25 | $223.87 |
Medica Setting Professional Modifier None Typical Low $120.23 Median $275.42 Typical High $891.25 | Professional | None | $120.23 | $275.42 | $891.25 |
Midlands Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $257.04 | Professional | None | $186.21 | $186.21 | $257.04 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $177.83 Typical High $251.19 | Professional | None | $169.82 | $177.83 | $251.19 |
Sanford Health Plan Setting Professional Modifier None Typical Low $120.23 Median $165.96 Typical High $229.09 | Professional | None | $120.23 | $165.96 | $229.09 |
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 $95.50 Median $213.80 Typical High $323.59 | Professional | None | $95.50 | $213.80 | $323.59 |
Wellmark Setting Professional Modifier None Typical Low $147.91 Median $173.78 Typical High $316.23 | Professional | None | $147.91 | $173.78 | $316.23 |
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 $32.36 Median $50.12 Typical High $58.88 | Professional | 52 · Reduced service | $32.36 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $19.95 Typical High $23.44 | Professional | 53 · Discontinued | $12.88 | $19.95 | $23.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $47.86 Median $74.13 Typical High $87.10 | Professional | 54 · Surgery only | $47.86 | $74.13 | $87.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $14.79 Typical High $17.38 | Professional | 55 · Aftercare only | $9.77 | $14.79 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $10.00 Typical High $11.75 | Professional | 56 · Pre-op care only | $6.46 | $10.00 | $11.75 |
Where South Dakota sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 7th of 51
$186
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.