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 $213.80 Median $281.84 Typical High $4,365.16 | Facility | None | $213.80 | $281.84 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $239.88 Typical High $316.23 | Professional | None | $177.83 | $239.88 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $234.42 Typical High $524.81 | Facility | None | $199.53 | $234.42 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $537.03 Typical High $831.76 | Professional | None | $338.84 | $537.03 | $831.76 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $398.11 Typical High $758.58 | Facility | None | $302.00 | $398.11 | $758.58 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $602.56 Typical High $1,548.82 | Professional | None | $257.04 | $602.56 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $501.19 Median $660.69 Typical High $660.69 | Professional | None | $501.19 | $660.69 | $660.69 |
Midlands Setting Facility Modifier None Typical Low $199.53 Median $223.87 Typical High $263.03 | Facility | None | $199.53 | $223.87 | $263.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $295.12 Median $436.52 Typical High $575.44 | Professional | None | $295.12 | $436.52 | $575.44 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $245.47 Median $501.19 Typical High $794.33 | Professional | None | $245.47 | $501.19 | $794.33 |
Wellmark Setting Professional Modifier None Typical Low $354.81 Median $426.58 Typical High $724.44 | Professional | None | $354.81 | $426.58 | $724.44 |
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 $89.13 Median $117.49 Typical High $151.36 | Professional | 52 · Reduced service | $89.13 | $117.49 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $47.86 Typical High $60.26 | Professional | 53 · Discontinued | $35.48 | $47.86 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $177.83 Typical High $223.87 | Professional | 54 · Surgery only | $134.90 | $177.83 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $35.48 Typical High $44.67 | Professional | 55 · Aftercare only | $26.92 | $35.48 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $23.99 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.78 | $23.99 | $30.20 |
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· 6th of 51
$457
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.