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 $41.69 Median $60.26 Typical High $4,365.16 | Facility | None | $41.69 | $60.26 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $35.48 Median $46.77 Typical High $64.57 | Professional | None | $35.48 | $46.77 | $64.57 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $89.13 Typical High $112.20 | Facility | None | $69.18 | $89.13 | $112.20 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $117.49 Typical High $177.83 | Professional | None | $69.18 | $117.49 | $177.83 |
Medica Setting Facility Modifier None Typical Low $58.88 Median $89.13 Typical High $223.87 | Facility | None | $58.88 | $89.13 | $223.87 |
Medica Setting Professional Modifier None Typical Low $52.48 Median $120.23 Typical High $707.95 | Professional | None | $52.48 | $120.23 | $707.95 |
Midlands Setting Professional Modifier None Typical Low $97.72 Median $134.90 Typical High $134.90 | Professional | None | $97.72 | $134.90 | $134.90 |
Midlands Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Sanford Health Plan Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $123.03 | Professional | None | $57.54 | $85.11 | $123.03 |
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 $50.12 Median $107.15 Typical High $165.96 | Professional | None | $50.12 | $107.15 | $165.96 |
Wellmark Setting Professional Modifier None Typical Low $79.43 Median $95.50 Typical High $162.18 | Professional | None | $79.43 | $95.50 | $162.18 |
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 $17.78 Median $26.30 Typical High $32.36 | Professional | 52 · Reduced service | $17.78 | $26.30 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.08 Median $10.47 Typical High $12.88 | Professional | 53 · Discontinued | $7.08 | $10.47 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $26.30 Median $39.81 Typical High $47.86 | Professional | 54 · Surgery only | $26.30 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $7.94 Typical High $9.77 | Professional | 55 · Aftercare only | $5.25 | $7.94 | $9.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.55 Median $5.25 Typical High $6.46 | Professional | 56 · Pre-op care only | $3.55 | $5.25 | $6.46 |
Where South Dakota sits
The same service costs 3.8 times more in Alaska than in Maryland. 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
$95.50
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.