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 $245.47 Median $316.23 Typical High $4,365.16 | Facility | None | $245.47 | $316.23 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $269.15 Typical High $371.54 | Professional | None | $208.93 | $269.15 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $954.99 Typical High $1,047.13 | Facility | None | $467.74 | $954.99 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $933.25 | Professional | None | $512.86 | $660.69 | $933.25 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $457.09 Typical High $1,202.26 | Facility | None | $323.59 | $457.09 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $758.58 Typical High $2,344.23 | Professional | None | $275.42 | $758.58 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $707.95 | Professional | None | $562.34 | $562.34 | $707.95 |
Midlands Setting Facility Modifier None Typical Low $812.83 Median $954.99 Typical High $1,202.26 | Facility | None | $812.83 | $954.99 | $1,202.26 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $645.65 | Professional | None | $512.86 | $512.86 | $645.65 |
Sanford Health Plan Setting Professional Modifier None Typical Low $316.23 Median $467.74 Typical High $616.60 | Professional | None | $316.23 | $467.74 | $616.60 |
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 $263.03 Median $501.19 Typical High $870.96 | Professional | None | $263.03 | $501.19 | $870.96 |
Wellmark Setting Professional Modifier None Typical Low $457.09 Median $524.81 Typical High $758.58 | Professional | None | $457.09 | $524.81 | $758.58 |
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 $104.71 Median $134.90 Typical High $169.82 | Professional | 52 · Reduced service | $104.71 | $134.90 | $169.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $53.70 Typical High $67.61 | Professional | 53 · Discontinued | $41.69 | $53.70 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $204.17 Typical High $251.19 | Professional | 54 · Surgery only | $154.88 | $204.17 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $40.74 Typical High $50.12 | Professional | 55 · Aftercare only | $30.90 | $40.74 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $26.92 Typical High $33.88 | Professional | 56 · Pre-op care only | $20.89 | $26.92 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $190.55 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $144.54 | $190.55 | $234.42 |
Where South Dakota sits
The same service costs 4.8 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· 4th of 51
$562
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.