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 $109.65 Median $162.18 Typical High $4,365.16 | Facility | None | $109.65 | $162.18 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $177.83 | Professional | None | $93.33 | $138.04 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $295.12 | Facility | None | $125.89 | $158.49 | $295.12 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $478.63 | Professional | None | $229.09 | $323.59 | $478.63 |
Medica Setting Facility Modifier None Typical Low $144.54 Median $234.42 Typical High $758.58 | Facility | None | $144.54 | $234.42 | $758.58 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $389.05 Typical High $1,202.26 | Professional | None | $141.25 | $389.05 | $1,202.26 |
Midlands Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $363.08 | Professional | None | $251.19 | $251.19 | $363.08 |
Midlands Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $169.82 | Facility | None | $125.89 | $151.36 | $169.82 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $331.13 | Professional | None | $223.87 | $223.87 | $331.13 |
Sanford Health Plan Setting Professional Modifier None Typical Low $147.91 Median $218.78 Typical High $309.03 | Professional | None | $147.91 | $218.78 | $309.03 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $128.82 Median $239.88 Typical High $446.68 | Professional | None | $128.82 | $239.88 | $446.68 |
Wellmark Setting Professional Modifier None Typical Low $194.98 Median $229.09 Typical High $363.08 | Professional | None | $194.98 | $229.09 | $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 $46.77 Median $69.18 Typical High $79.43 | Professional | 52 · Reduced service | $46.77 | $69.18 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $27.54 Typical High $32.36 | Professional | 53 · Discontinued | $18.62 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $104.71 Typical High $120.23 | Professional | 54 · Surgery only | $69.18 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $20.89 Typical High $23.99 | Professional | 55 · Aftercare only | $14.13 | $20.89 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $13.80 Typical High $16.22 | Professional | 56 · Pre-op care only | $9.33 | $13.80 | $16.22 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $97.72 Typical High $112.20 | Professional | 78 · Unplanned return to OR | $64.57 | $97.72 | $112.20 |
Where South Dakota sits
The same service costs 3.5 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
$251
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.