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 $223.87 Median $5,128.61 Typical High $5,128.61 | Facility | None | $223.87 | $5,128.61 | $5,128.61 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $251.19 | Professional | None | $138.04 | $190.55 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $812.83 Typical High $1,047.13 | Facility | None | $331.13 | $812.83 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $467.74 Typical High $575.44 | Professional | None | $338.84 | $467.74 | $575.44 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $323.59 Typical High $1,202.26 | Facility | None | $234.42 | $323.59 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $537.03 Typical High $1,659.59 | Professional | None | $194.98 | $537.03 | $1,659.59 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $380.19 Typical High $501.19 | Professional | None | $371.54 | $380.19 | $501.19 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $870.96 Typical High $1,047.13 | Facility | None | $645.65 | $870.96 | $1,047.13 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $446.68 | Professional | None | $331.13 | $331.13 | $446.68 |
Sanford Health Plan Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $436.52 | Professional | None | $223.87 | $323.59 | $436.52 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $181.97 Median $338.84 Typical High $616.60 | Professional | None | $181.97 | $338.84 | $616.60 |
Wellmark Setting Professional Modifier None Typical Low $302.00 Median $346.74 Typical High $524.81 | Professional | None | $302.00 | $346.74 | $524.81 |
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 $69.18 Median $95.50 Typical High $112.20 | Professional | 52 · Reduced service | $69.18 | $95.50 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $38.02 Typical High $44.67 | Professional | 53 · Discontinued | $27.54 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $144.54 Typical High $169.82 | Professional | 54 · Surgery only | $104.71 | $144.54 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $28.84 Typical High $33.88 | Professional | 55 · Aftercare only | $20.89 | $28.84 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $19.05 Typical High $22.39 | Professional | 56 · Pre-op care only | $13.80 | $19.05 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $134.90 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $97.72 | $134.90 | $158.49 |
Where South Dakota sits
The same service costs 4.6 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
$372
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.