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 $104.71 Median $154.88 Typical High $4,365.16 | Facility | None | $104.71 | $154.88 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $173.78 | Professional | None | $91.20 | $125.89 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $158.49 Typical High $281.84 | Facility | None | $131.83 | $158.49 | $281.84 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $316.23 Typical High $389.05 | Professional | None | $223.87 | $316.23 | $389.05 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $154.88 Typical High $251.19 | Facility | None | $125.89 | $154.88 | $251.19 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $380.19 Typical High $1,122.02 | Professional | None | $131.83 | $380.19 | $1,122.02 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $346.74 | Professional | None | $239.88 | $239.88 | $346.74 |
Midlands Setting Facility Modifier None Typical Low $131.83 Median $154.88 Typical High $181.97 | Facility | None | $131.83 | $154.88 | $181.97 |
Midlands Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $295.12 | Professional | None | $194.98 | $194.98 | $295.12 |
Sanford Health Plan Setting Professional Modifier None Typical Low $144.54 Median $208.93 Typical High $295.12 | Professional | None | $144.54 | $208.93 | $295.12 |
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 $123.03 Median $229.09 Typical High $426.58 | Professional | None | $123.03 | $229.09 | $426.58 |
Wellmark Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $363.08 | Professional | None | $204.17 | $234.42 | $363.08 |
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 $45.71 Median $66.07 Typical High $75.86 | Professional | 52 · Reduced service | $45.71 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $26.30 Typical High $30.90 | Professional | 53 · Discontinued | $18.20 | $26.30 | $30.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $97.72 Typical High $114.82 | Professional | 54 · Surgery only | $67.61 | $97.72 | $114.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $19.95 Typical High $22.91 | Professional | 55 · Aftercare only | $13.49 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $13.18 Typical High $15.14 | Professional | 56 · Pre-op care only | $9.12 | $13.18 | $15.14 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $91.20 Typical High $107.15 | Professional | 78 · Unplanned return to OR | $63.10 | $91.20 | $107.15 |
Where South Dakota sits
The same service costs 4.1 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· 7th of 51
$240
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.