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 $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $190.55 | Professional | None | $181.97 | $181.97 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $245.47 Typical High $309.03 | Facility | None | $169.82 | $245.47 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $186.21 Typical High $234.42 | Professional | None | $23.99 | $186.21 | $234.42 |
Medica Setting Facility Modifier None Typical Low $309.03 Median $309.03 Typical High $501.19 | Facility | None | $309.03 | $309.03 | $501.19 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $181.97 Typical High $812.83 | Professional | None | $173.78 | $181.97 | $812.83 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Midlands Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $204.17 | Facility | None | $169.82 | $169.82 | $204.17 |
Sanford Health Plan Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $426.58 | Professional | None | $426.58 | $426.58 | $426.58 |
United Setting Professional Modifier None Typical Low $120.23 Median $125.89 Typical High $141.25 | Professional | None | $120.23 | $125.89 | $141.25 |
Wellmark Setting Facility Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Facility | None | $181.97 | $181.97 | $181.97 |
Wellmark Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | None | $181.97 | $181.97 | $181.97 |
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 $91.20 Median $91.20 Typical High $95.50 | Professional | 52 · Reduced service | $91.20 | $91.20 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $36.31 Typical High $38.02 | Professional | 53 · Discontinued | $36.31 | $36.31 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $138.04 Typical High $141.25 | Professional | 54 · Surgery only | $138.04 | $138.04 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $27.54 Typical High $28.18 | Professional | 55 · Aftercare only | $27.54 | $27.54 | $28.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $18.20 Typical High $19.05 | Professional | 56 · Pre-op care only | $18.20 | $18.20 | $19.05 |
Where South Dakota sits
The same service costs 3.6 times more in Wyoming than in North Carolina. 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· 13th of 51
$182
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.