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 $51.29 Median $69.18 Typical High $4,365.16 | Facility | None | $51.29 | $69.18 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $43.65 Median $60.26 Typical High $74.13 | Professional | None | $43.65 | $60.26 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $100.00 Typical High $125.89 | Facility | None | $44.67 | $100.00 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $83.18 Median $147.91 Typical High $173.78 | Professional | None | $83.18 | $147.91 | $173.78 |
Medica Setting Facility Modifier None Typical Low $74.13 Median $102.33 Typical High $223.87 | Facility | None | $74.13 | $102.33 | $223.87 |
Medica Setting Professional Modifier None Typical Low $63.10 Median $141.25 Typical High $380.19 | Professional | None | $63.10 | $141.25 | $380.19 |
Midlands Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $158.49 | Professional | None | $123.03 | $158.49 | $158.49 |
Midlands Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Sanford Health Plan Setting Professional Modifier None Typical Low $70.79 Median $97.72 Typical High $138.04 | Professional | None | $70.79 | $97.72 | $138.04 |
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 $58.88 Median $123.03 Typical High $190.55 | Professional | None | $58.88 | $123.03 | $190.55 |
Wellmark Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $169.82 | Professional | None | $87.10 | $107.15 | $169.82 |
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 $21.88 Median $30.20 Typical High $36.31 | Professional | 52 · Reduced service | $21.88 | $30.20 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $12.02 Typical High $14.79 | Professional | 53 · Discontinued | $8.71 | $12.02 | $14.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.11 Median $44.67 Typical High $54.95 | Professional | 54 · Surgery only | $33.11 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $8.91 Typical High $10.96 | Professional | 55 · Aftercare only | $6.61 | $8.91 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $6.03 Typical High $7.24 | Professional | 56 · Pre-op care only | $4.37 | $6.03 | $7.24 |
Where South Dakota sits
The same service costs 3.6 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
$112
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.