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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,698.24 | Professional | None | $1,659.59 | $1,659.59 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $436.52 Typical High $549.54 | Facility | None | $169.82 | $436.52 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $1,949.84 | Professional | None | $331.13 | $407.38 | $1,949.84 |
Medica Setting Facility Modifier None Typical Low $1,548.82 Median $2,754.23 Typical High $2,754.23 | Facility | None | $1,548.82 | $2,754.23 | $2,754.23 |
Medica Setting Professional Modifier None Typical Low $323.59 Median $1,659.59 Typical High $5,888.44 | Professional | None | $323.59 | $1,659.59 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $1,949.84 Median $1,949.84 Typical High $1,949.84 | Professional | None | $1,949.84 | $1,949.84 | $1,949.84 |
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 $1,318.26 Median $1,318.26 Typical High $1,318.26 | Professional | None | $1,318.26 | $1,318.26 | $1,318.26 |
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 $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Wellmark Setting Professional Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,659.59 | $1,659.59 | $1,659.59 |
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 $812.83 Median $812.83 Typical High $851.14 | Professional | 52 · Reduced service | $812.83 | $812.83 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $331.13 Typical High $338.84 | Professional | 53 · Discontinued | $331.13 | $331.13 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,230.27 Median $1,230.27 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,230.27 | $1,230.27 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $245.47 Median $245.47 Typical High $257.04 | Professional | 55 · Aftercare only | $245.47 | $245.47 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $165.96 Typical High $169.82 | Professional | 56 · Pre-op care only | $165.96 | $165.96 | $169.82 |
Where South Dakota sits
The same service costs 15.1 times more in Arkansas 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· 11th of 51
$1,660
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.