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 $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Aetna Setting Professional Modifier None Typical Low $45.71 Median $45.71 Typical High $53.70 | Professional | None | $45.71 | $45.71 | $53.70 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $194.98 Typical High $245.47 | Facility | None | $169.82 | $194.98 | $245.47 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $181.97 | Professional | None | $147.91 | $147.91 | $181.97 |
Medica Setting Facility Modifier None Typical Low $53.70 Median $81.28 Typical High $81.28 | Facility | None | $53.70 | $81.28 | $81.28 |
Medica Setting Professional Modifier None Typical Low $41.69 Median $44.67 Typical High $138.04 | Professional | None | $41.69 | $44.67 | $138.04 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
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 $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
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 $30.20 Median $30.20 Typical High $30.20 | Facility | None | $30.20 | $30.20 | $30.20 |
Wellmark Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $30.20 | Professional | None | $30.20 | $30.20 | $30.20 |
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 $22.39 Median $22.39 Typical High $26.92 | Professional | 52 · Reduced service | $22.39 | $22.39 | $26.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $9.12 Typical High $10.72 | Professional | 53 · Discontinued | $9.12 | $9.12 | $10.72 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $33.88 Median $33.88 Typical High $39.81 | Professional | 54 · Surgery only | $33.88 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $6.76 Typical High $7.94 | Professional | 55 · Aftercare only | $6.76 | $6.76 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $4.57 Typical High $5.37 | Professional | 56 · Pre-op care only | $4.57 | $4.57 | $5.37 |
Where South Dakota sits
The same service costs 6.3 times more in North Dakota than in Hawaii. 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· 38th of 51
$60.26
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.