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 $34.67 Median $41.69 Typical High $4,365.16 | Facility | None | $34.67 | $41.69 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $29.51 Median $36.31 Typical High $46.77 | Professional | None | $29.51 | $36.31 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $28.18 Median $61.66 Typical High $77.62 | Facility | None | $28.18 | $61.66 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $56.23 Median $93.33 Typical High $123.03 | Professional | None | $56.23 | $93.33 | $123.03 |
Medica Setting Facility Modifier None Typical Low $50.12 Median $61.66 Typical High $151.36 | Facility | None | $50.12 | $61.66 | $151.36 |
Medica Setting Professional Modifier None Typical Low $37.15 Median $87.10 Typical High $416.87 | Professional | None | $37.15 | $87.10 | $416.87 |
Midlands Setting Professional Modifier None Typical Low $81.28 Median $95.50 Typical High $95.50 | Professional | None | $81.28 | $95.50 | $95.50 |
Midlands Setting Facility Modifier None Typical Low $28.18 Median $28.18 Typical High $28.18 | Facility | None | $28.18 | $28.18 | $28.18 |
Sanford Health Plan Setting Professional Modifier None Typical Low $46.77 Median $66.07 Typical High $89.13 | Professional | None | $46.77 | $66.07 | $89.13 |
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 $37.15 Median $75.86 Typical High $117.49 | Professional | None | $37.15 | $75.86 | $117.49 |
Wellmark Setting Professional Modifier None Typical Low $60.26 Median $74.13 Typical High $104.71 | Professional | None | $60.26 | $74.13 | $104.71 |
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 $14.79 Median $18.20 Typical High $22.39 | Professional | 52 · Reduced service | $14.79 | $18.20 | $22.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $7.24 Typical High $8.91 | Professional | 53 · Discontinued | $5.89 | $7.24 | $8.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $22.39 Median $27.54 Typical High $33.11 | Professional | 54 · Surgery only | $22.39 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $5.50 Typical High $6.61 | Professional | 55 · Aftercare only | $4.47 | $5.50 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.63 Typical High $4.47 | Professional | 56 · Pre-op care only | $2.95 | $3.63 | $4.47 |
Where South Dakota sits
The same service costs 3.8 times more in Alaska than in Utah. 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
$74.13
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.