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 $208.93 Typical High $4,365.16 | Facility | None | $181.97 | $208.93 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $181.97 Typical High $263.03 | Professional | None | $158.49 | $181.97 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $177.83 Typical High $398.11 | Facility | None | $117.49 | $177.83 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $630.96 | Professional | None | $354.81 | $457.09 | $630.96 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $263.03 Typical High $426.58 | Facility | None | $125.89 | $263.03 | $426.58 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $512.86 Typical High $1,584.89 | Professional | None | $181.97 | $512.86 | $1,584.89 |
Midlands Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $467.74 | Professional | None | $416.87 | $416.87 | $467.74 |
Midlands Setting Facility Modifier None Typical Low $117.49 Median $173.78 Typical High $208.93 | Facility | None | $117.49 | $173.78 | $208.93 |
Midlands Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $416.87 | Professional | None | $363.08 | $363.08 | $416.87 |
Sanford Health Plan Setting Professional Modifier None Typical Low $218.78 Median $331.13 Typical High $416.87 | Professional | None | $218.78 | $331.13 | $416.87 |
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 $173.78 Median $371.54 Typical High $588.84 | Professional | None | $173.78 | $371.54 | $588.84 |
Wellmark Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $501.19 | Professional | None | $346.74 | $398.11 | $501.19 |
6 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 $79.43 Median $91.20 Typical High $125.89 | Professional | 52 · Reduced service | $79.43 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $37.15 Typical High $50.12 | Professional | 53 · Discontinued | $31.62 | $37.15 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $138.04 Typical High $186.21 | Professional | 54 · Surgery only | $117.49 | $138.04 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $27.54 Typical High $37.15 | Professional | 55 · Aftercare only | $23.44 | $27.54 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.20 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.85 | $18.20 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $109.65 Median $128.82 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $109.65 | $128.82 | $173.78 |
Where South Dakota sits
The same service costs 4.4 times more in Alaska than in Florida. 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· 4th of 51
$398
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.