How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $93.33 Median $512.86 Typical High $4,365.16 | Facility | None | $93.33 | $512.86 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $112.20 Typical High $707.95 | Professional | None | $89.13 | $112.20 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $158.49 Median $562.34 Typical High $1,548.82 | Professional | None | $158.49 | $562.34 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $128.82 Median $269.15 Typical High $1,202.26 | Facility | None | $128.82 | $269.15 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $912.01 Typical High $4,677.35 | Professional | None | $218.78 | $912.01 | $4,677.35 |
Midlands Setting Professional Modifier None Typical Low $181.97 Median $229.09 Typical High $741.31 | Professional | None | $181.97 | $229.09 | $741.31 |
Midlands Setting Professional Modifier None Typical Low $104.71 Median $204.17 Typical High $1,348.96 | Professional | None | $104.71 | $204.17 | $1,348.96 |
Sanford Health Plan Setting Professional Modifier None Typical Low $104.71 Median $269.15 Typical High $1,122.02 | Professional | None | $104.71 | $269.15 | $1,122.02 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
United Setting Professional Modifier None Typical Low $109.65 Median $194.98 Typical High $1,071.52 | Professional | None | $109.65 | $194.98 | $1,071.52 |
Wellmark Setting Professional Modifier None Typical Low $151.36 Median $186.21 Typical High $1,737.80 | Professional | None | $151.36 | $186.21 | $1,737.80 |
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 $44.67 Median $54.95 Typical High $354.81 | Professional | 52 · Reduced service | $44.67 | $54.95 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.78 Median $22.39 Typical High $141.25 | Professional | 53 · Discontinued | $17.78 | $22.39 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $83.18 Typical High $537.03 | Professional | 54 · Surgery only | $67.61 | $83.18 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.60 Typical High $107.15 | Professional | 55 · Aftercare only | $13.49 | $16.60 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $11.22 Typical High $70.79 | Professional | 56 · Pre-op care only | $8.91 | $11.22 | $70.79 |
Where South Dakota sits
The same service costs 9.5 times more in Washington than in Washington, DC. 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· 12th of 51
$407
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.