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 $26.92 Median $28.18 Typical High $4,365.16 | Facility | None | $26.92 | $28.18 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $16.60 Median $20.89 Typical High $47.86 | Professional | None | $16.60 | $20.89 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $29.51 Typical High $34.67 | Facility | None | $28.18 | $29.51 | $34.67 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $52.48 Typical High $75.86 | Professional | None | $32.36 | $52.48 | $75.86 |
Medica Setting Facility Modifier None Typical Low $27.54 Median $33.11 Typical High $151.36 | Facility | None | $27.54 | $33.11 | $151.36 |
Medica Setting Professional Modifier None Typical Low $24.55 Median $74.13 Typical High $302.00 | Professional | None | $24.55 | $74.13 | $302.00 |
Midlands Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $81.28 | Professional | None | $75.86 | $75.86 | $81.28 |
Midlands Setting Facility Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Facility | None | $29.51 | $29.51 | $29.51 |
Sanford Health Plan Setting Professional Modifier None Typical Low $26.92 Median $40.74 Typical High $81.28 | Professional | None | $26.92 | $40.74 | $81.28 |
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 $25.70 Median $72.44 Typical High $107.15 | Professional | None | $25.70 | $72.44 | $107.15 |
Wellmark Setting Professional Modifier None Typical Low $38.90 Median $47.86 Typical High $48.98 | Professional | None | $38.90 | $47.86 | $48.98 |
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 $8.13 Median $9.77 Typical High $14.13 | Professional | 52 · Reduced service | $8.13 | $9.77 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.89 Typical High $5.75 | Professional | 53 · Discontinued | $3.31 | $3.89 | $5.75 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $12.30 Median $14.45 Typical High $21.38 | Professional | 54 · Surgery only | $12.30 | $14.45 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.45 Median $2.88 Typical High $4.27 | Professional | 55 · Aftercare only | $2.45 | $2.88 | $4.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.95 Typical High $2.82 | Professional | 56 · Pre-op care only | $1.62 | $1.95 | $2.82 |
Where South Dakota sits
The same service costs 4.3 times more in Wyoming than in New York. 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· 15th of 51
$48.98
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.