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 $81.28 Median $204.17 Typical High $204.17 | Facility | None | $81.28 | $204.17 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $38.90 Median $67.61 Typical High $131.83 | Professional | None | $38.90 | $67.61 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $45.71 Median $120.23 Typical High $147.91 | Facility | None | $45.71 | $120.23 | $147.91 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $138.04 Typical High $239.88 | Professional | None | $109.65 | $138.04 | $239.88 |
Medica Setting Facility Modifier None Typical Low $66.07 Median $114.82 Typical High $223.87 | Facility | None | $66.07 | $114.82 | $223.87 |
Medica Setting Professional Modifier None Typical Low $91.20 Median $218.78 Typical High $645.65 | Professional | None | $91.20 | $218.78 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $186.21 | Professional | None | $109.65 | $109.65 | $186.21 |
Midlands Setting Facility Modifier None Typical Low $45.71 Median $45.71 Typical High $45.71 | Facility | None | $45.71 | $45.71 | $45.71 |
Midlands Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $165.96 | Professional | None | $97.72 | $97.72 | $165.96 |
Sanford Health Plan Setting Professional Modifier None Typical Low $64.57 Median $109.65 Typical High $154.88 | Professional | None | $64.57 | $109.65 | $154.88 |
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 $56.23 Median $128.82 Typical High $223.87 | Professional | None | $56.23 | $128.82 | $223.87 |
Wellmark Setting Professional Modifier None Typical Low $83.18 Median $102.33 Typical High $199.53 | Professional | None | $83.18 | $102.33 | $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 $19.50 Median $23.44 Typical High $39.81 | Professional | 52 · Reduced service | $19.50 | $23.44 | $39.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.76 Median $9.33 Typical High $15.85 | Professional | 53 · Discontinued | $7.76 | $9.33 | $15.85 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $28.84 Median $34.67 Typical High $60.26 | Professional | 54 · Surgery only | $28.84 | $34.67 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $7.08 Typical High $12.02 | Professional | 55 · Aftercare only | $5.75 | $7.08 | $12.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.89 Median $4.68 Typical High $7.94 | Professional | 56 · Pre-op care only | $3.89 | $4.68 | $7.94 |
Where South Dakota sits
The same service costs 3.3 times more in Alaska than in Kentucky. 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· 10th of 51
$123
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.