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 $123.03 Median $213.80 Typical High $4,897.79 | Facility | None | $123.03 | $213.80 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $190.55 Typical High $323.59 | Professional | None | $102.33 | $190.55 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $199.53 Typical High $416.87 | Facility | None | $151.36 | $199.53 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $380.19 Typical High $660.69 | Professional | None | $288.40 | $380.19 | $660.69 |
Medica Setting Facility Modifier None Typical Low $169.82 Median $323.59 Typical High $1,202.26 | Facility | None | $169.82 | $323.59 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $562.34 Typical High $6,456.54 | Professional | None | $213.80 | $562.34 | $6,456.54 |
Midlands Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $467.74 | Professional | None | $288.40 | $288.40 | $467.74 |
Midlands Setting Facility Modifier None Typical Low $151.36 Median $199.53 Typical High $1,380.38 | Facility | None | $151.36 | $199.53 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $436.52 | Professional | None | $257.04 | $257.04 | $436.52 |
Sanford Health Plan Setting Professional Modifier None Typical Low $199.53 Median $316.23 Typical High $489.78 | Professional | None | $199.53 | $316.23 | $489.78 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $162.18 Median $338.84 Typical High $588.84 | Professional | None | $162.18 | $338.84 | $588.84 |
Wellmark Setting Professional Modifier None Typical Low $213.80 Median $263.03 Typical High $549.54 | Professional | None | $213.80 | $263.03 | $549.54 |
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 $51.29 Median $61.66 Typical High $112.20 | Professional | 52 · Reduced service | $51.29 | $61.66 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $24.55 Typical High $44.67 | Professional | 53 · Discontinued | $20.42 | $24.55 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $91.20 Typical High $169.82 | Professional | 54 · Surgery only | $75.86 | $91.20 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.62 Typical High $33.88 | Professional | 55 · Aftercare only | $15.14 | $18.62 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.30 Typical High $22.39 | Professional | 56 · Pre-op care only | $10.23 | $12.30 | $22.39 |
Where South Dakota sits
The same service costs 3.2 times more in Oklahoma than in Texas. 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
$324
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.