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 $50.12 Median $63.10 Typical High $4,365.16 | Facility | None | $50.12 | $63.10 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $54.95 Typical High $67.61 | Professional | None | $41.69 | $54.95 | $67.61 |
Cigna Setting Facility Modifier None Typical Low $40.74 Median $47.86 Typical High $117.49 | Facility | None | $40.74 | $47.86 | $117.49 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $173.78 | Professional | None | $79.43 | $141.25 | $173.78 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $93.33 Typical High $173.78 | Facility | None | $70.79 | $93.33 | $173.78 |
Medica Setting Professional Modifier None Typical Low $57.54 Median $128.82 Typical High $436.52 | Professional | None | $57.54 | $128.82 | $436.52 |
Midlands Setting Professional Modifier None Typical Low $117.49 Median $144.54 Typical High $144.54 | Professional | None | $117.49 | $144.54 | $144.54 |
Midlands Setting Facility Modifier None Typical Low $40.74 Median $46.77 Typical High $52.48 | Facility | None | $40.74 | $46.77 | $52.48 |
Sanford Health Plan Setting Professional Modifier None Typical Low $67.61 Median $93.33 Typical High $125.89 | Professional | None | $67.61 | $93.33 | $125.89 |
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 $54.95 Median $114.82 Typical High $177.83 | Professional | None | $54.95 | $114.82 | $177.83 |
Wellmark Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $158.49 | Professional | None | $83.18 | $102.33 | $158.49 |
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 $20.89 Median $27.54 Typical High $33.88 | Professional | 52 · Reduced service | $20.89 | $27.54 | $33.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $10.96 Typical High $13.49 | Professional | 53 · Discontinued | $8.32 | $10.96 | $13.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $30.90 Median $41.69 Typical High $51.29 | Professional | 54 · Surgery only | $30.90 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $8.32 Typical High $10.23 | Professional | 55 · Aftercare only | $6.17 | $8.32 | $10.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.50 Typical High $6.76 | Professional | 56 · Pre-op care only | $4.17 | $5.50 | $6.76 |
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· 6th 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.