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 $97.72 Median $562.34 Typical High $2,290.87 | Facility | None | $97.72 | $562.34 | $2,290.87 |
Aetna Setting Professional Modifier None Typical Low $28.18 Median $69.18 Typical High $112.20 | Professional | None | $28.18 | $69.18 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $151.36 Typical High $186.21 | Facility | None | $151.36 | $151.36 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $40.74 Median $125.89 Typical High $269.15 | Professional | None | $40.74 | $125.89 | $269.15 |
Medica Setting Facility Modifier None Typical Low $58.88 Median $125.89 Typical High $275.42 | Facility | None | $58.88 | $125.89 | $275.42 |
Medica Setting Professional Modifier None Typical Low $64.57 Median $87.10 Typical High $645.65 | Professional | None | $64.57 | $87.10 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $144.54 | Professional | None | $40.74 | $44.67 | $144.54 |
Midlands Setting Professional Modifier None Typical Low $41.69 Median $41.69 Typical High $109.65 | Professional | None | $41.69 | $41.69 | $109.65 |
Sanford Health Plan Setting Professional Modifier None Typical Low $57.54 Median $109.65 Typical High $186.21 | Professional | None | $57.54 | $109.65 | $186.21 |
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 $23.44 Median $57.54 Typical High $114.82 | Professional | None | $23.44 | $57.54 | $114.82 |
Wellmark Setting Professional Modifier None Typical Low $44.67 Median $48.98 Typical High $158.49 | Professional | None | $44.67 | $48.98 | $158.49 |
3 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 54 · Surgery only Typical Low $26.30 Median $57.54 Typical High $85.11 | Professional | 54 · Surgery only | $26.30 | $57.54 | $85.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.25 Median $11.48 Typical High $16.98 | Professional | 55 · Aftercare only | $5.25 | $11.48 | $16.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $7.59 Typical High $11.22 | Professional | 56 · Pre-op care only | $3.47 | $7.59 | $11.22 |
Where South Dakota sits
The same service costs 2.8 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· 15th of 51
$89.13
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.