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 $102.33 Median $117.49 Typical High $4,365.16 | Facility | None | $102.33 | $117.49 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $100.00 Typical High $123.03 | Professional | None | $87.10 | $100.00 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $169.82 Typical High $213.80 | Facility | None | $69.18 | $169.82 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $257.04 Typical High $338.84 | Professional | None | $169.82 | $257.04 | $338.84 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $239.88 | Facility | None | $125.89 | $151.36 | $239.88 |
Medica Setting Professional Modifier None Typical Low $102.33 Median $239.88 Typical High $812.83 | Professional | None | $102.33 | $239.88 | $812.83 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $269.15 Typical High $269.15 | Professional | None | $239.88 | $269.15 | $269.15 |
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 $123.03 Median $186.21 Typical High $234.42 | Professional | None | $123.03 | $186.21 | $234.42 |
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 $102.33 Median $208.93 Typical High $323.59 | Professional | None | $102.33 | $208.93 | $323.59 |
Wellmark Setting Professional Modifier None Typical Low $177.83 Median $218.78 Typical High $295.12 | Professional | None | $177.83 | $218.78 | $295.12 |
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 $43.65 Median $50.12 Typical High $61.66 | Professional | 52 · Reduced service | $43.65 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $19.95 Typical High $24.55 | Professional | 53 · Discontinued | $17.38 | $19.95 | $24.55 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $75.86 Typical High $93.33 | Professional | 54 · Surgery only | $66.07 | $75.86 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $15.14 Typical High $18.62 | Professional | 55 · Aftercare only | $13.18 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $10.00 Typical High $12.30 | Professional | 56 · Pre-op care only | $8.71 | $10.00 | $12.30 |
Where South Dakota sits
The same service costs 4.5 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· 6th of 51
$204
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.