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 $61.66 Median $72.44 Typical High $4,365.16 | Facility | None | $61.66 | $72.44 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $67.61 Typical High $81.28 | Professional | None | $54.95 | $67.61 | $81.28 |
Cigna Setting Facility Modifier None Typical Low $51.29 Median $134.90 Typical High $218.78 | Facility | None | $51.29 | $134.90 | $218.78 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $158.49 Typical High $223.87 | Professional | None | $123.03 | $158.49 | $223.87 |
Medica Setting Facility Modifier None Typical Low $85.11 Median $114.82 Typical High $208.93 | Facility | None | $85.11 | $114.82 | $208.93 |
Medica Setting Professional Modifier None Typical Low $67.61 Median $162.18 Typical High $478.63 | Professional | None | $67.61 | $162.18 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $141.25 Median $165.96 Typical High $165.96 | Professional | None | $141.25 | $165.96 | $165.96 |
Midlands Setting Facility Modifier None Typical Low $48.98 Median $134.90 Typical High $239.88 | Facility | None | $48.98 | $134.90 | $239.88 |
Sanford Health Plan Setting Professional Modifier None Typical Low $89.13 Median $123.03 Typical High $158.49 | Professional | None | $89.13 | $123.03 | $158.49 |
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 $67.61 Median $147.91 Typical High $204.17 | Professional | None | $67.61 | $147.91 | $204.17 |
Wellmark Setting Professional Modifier None Typical Low $114.82 Median $141.25 Typical High $199.53 | Professional | None | $114.82 | $141.25 | $199.53 |
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 $27.54 Median $33.88 Typical High $40.74 | Professional | 52 · Reduced service | $27.54 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $13.49 Typical High $16.22 | Professional | 53 · Discontinued | $10.96 | $13.49 | $16.22 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $41.69 Median $50.12 Typical High $61.66 | Professional | 54 · Surgery only | $41.69 | $50.12 | $61.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.32 Median $10.00 Typical High $12.30 | Professional | 55 · Aftercare only | $8.32 | $10.00 | $12.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.76 Typical High $8.13 | Professional | 56 · Pre-op care only | $5.50 | $6.76 | $8.13 |
Where South Dakota sits
The same service costs 3.8 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
$135
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.