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 $79.43 Typical High $4,365.16 | Facility | None | $50.12 | $79.43 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $41.69 Median $66.07 Typical High $147.91 | Professional | None | $41.69 | $66.07 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $117.49 Typical High $144.54 | Facility | None | $66.07 | $117.49 | $144.54 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $147.91 Typical High $234.42 | Professional | None | $117.49 | $147.91 | $234.42 |
Medica Setting Facility Modifier None Typical Low $70.79 Median $109.65 Typical High $223.87 | Facility | None | $70.79 | $109.65 | $223.87 |
Medica Setting Professional Modifier None Typical Low $97.72 Median $208.93 Typical High $660.69 | Professional | None | $97.72 | $208.93 | $660.69 |
Midlands Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $181.97 | Professional | None | $117.49 | $117.49 | $181.97 |
Midlands Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $104.71 Typical High $162.18 | Professional | None | $104.71 | $104.71 | $162.18 |
Sanford Health Plan Setting Professional Modifier None Typical Low $77.62 Median $112.20 Typical High $162.18 | Professional | None | $77.62 | $112.20 | $162.18 |
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 $60.26 Median $141.25 Typical High $218.78 | Professional | None | $60.26 | $141.25 | $218.78 |
Wellmark Setting Professional Modifier None Typical Low $89.13 Median $109.65 Typical High $190.55 | Professional | None | $89.13 | $109.65 | $190.55 |
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 $25.12 Typical High $38.90 | Professional | 52 · Reduced service | $20.89 | $25.12 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.32 Median $10.23 Typical High $15.49 | Professional | 53 · Discontinued | $8.32 | $10.23 | $15.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $31.62 Median $38.02 Typical High $58.88 | Professional | 54 · Surgery only | $31.62 | $38.02 | $58.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $7.59 Typical High $11.75 | Professional | 55 · Aftercare only | $6.31 | $7.59 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.13 Typical High $7.76 | Professional | 56 · Pre-op care only | $4.17 | $5.13 | $7.76 |
Where South Dakota sits
The same service costs 3.2 times more in Wisconsin 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· 9th of 51
$126
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.