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 $58.88 Median $64.57 Typical High $4,365.16 | Facility | None | $58.88 | $64.57 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $50.12 Typical High $83.18 | Professional | None | $40.74 | $50.12 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $35.48 Median $74.13 Typical High $93.33 | Facility | None | $35.48 | $74.13 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $120.23 Typical High $165.96 | Professional | None | $77.62 | $120.23 | $165.96 |
Medica Setting Facility Modifier None Typical Low $64.57 Median $75.86 Typical High $223.87 | Facility | None | $64.57 | $75.86 | $223.87 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $177.83 Typical High $380.19 | Professional | None | $58.88 | $177.83 | $380.19 |
Midlands Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $181.97 | Professional | None | $165.96 | $165.96 | $181.97 |
Midlands Setting Facility Modifier None Typical Low $34.67 Median $54.95 Typical High $77.62 | Facility | None | $34.67 | $54.95 | $77.62 |
Sanford Health Plan Setting Professional Modifier None Typical Low $67.61 Median $89.13 Typical High $158.49 | Professional | None | $67.61 | $89.13 | $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 $58.88 Median $158.49 Typical High $194.98 | Professional | None | $58.88 | $158.49 | $194.98 |
Wellmark Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $131.83 | Professional | None | $79.43 | $97.72 | $131.83 |
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 $20.42 Median $22.39 Typical High $32.36 | Professional | 52 · Reduced service | $20.42 | $22.39 | $32.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.91 Typical High $12.88 | Professional | 53 · Discontinued | $8.13 | $8.91 | $12.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.20 Median $33.88 Typical High $47.86 | Professional | 54 · Surgery only | $30.20 | $33.88 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $6.76 Typical High $9.55 | Professional | 55 · Aftercare only | $6.03 | $6.76 | $9.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.47 Typical High $6.46 | Professional | 56 · Pre-op care only | $4.07 | $4.47 | $6.46 |
Where South Dakota sits
The same service costs 3.6 times more in Wyoming 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
$107
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.