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 $912.01 Typical High $2,290.87 | Facility | None | $102.33 | $912.01 | $2,290.87 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $134.90 | Professional | None | $79.43 | $100.00 | $134.90 |
Cigna Setting Facility Modifier None Typical Low $58.88 Median $87.10 Typical High $208.93 | Facility | None | $58.88 | $87.10 | $208.93 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $331.13 | Professional | None | $173.78 | $234.42 | $331.13 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $346.74 | Facility | None | $125.89 | $151.36 | $346.74 |
Medica Setting Professional Modifier None Typical Low $93.33 Median $229.09 Typical High $1,174.90 | Professional | None | $93.33 | $229.09 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $229.09 Median $234.42 Typical High $234.42 | Professional | None | $229.09 | $234.42 | $234.42 |
Midlands Setting Facility Modifier None Typical Low $58.88 Median $79.43 Typical High $102.33 | Facility | None | $58.88 | $79.43 | $102.33 |
Sanford Health Plan Setting Professional Modifier None Typical Low $125.89 Median $169.82 Typical High $331.13 | Professional | None | $125.89 | $169.82 | $331.13 |
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 $204.17 Typical High $281.84 | Professional | None | $102.33 | $204.17 | $281.84 |
Wellmark Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $288.40 | Professional | None | $158.49 | $190.55 | $288.40 |
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 $39.81 Median $48.98 Typical High $60.26 | Professional | 52 · Reduced service | $39.81 | $48.98 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $19.95 Typical High $23.99 | Professional | 53 · Discontinued | $15.85 | $19.95 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $58.88 Median $74.13 Typical High $91.20 | Professional | 54 · Surgery only | $58.88 | $74.13 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $14.79 Typical High $18.20 | Professional | 55 · Aftercare only | $11.75 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $7.94 | $10.00 | $12.02 |
Where South Dakota sits
The same service costs 3.7 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· 8th of 51
$191
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.