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 $281.84 Typical High $4,365.16 | Facility | None | $223.87 | $281.84 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $239.88 Typical High $323.59 | Professional | None | $190.55 | $239.88 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $416.87 Median $537.03 Typical High $954.99 | Facility | None | $416.87 | $537.03 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $588.84 Typical High $724.44 | Professional | None | $467.74 | $588.84 | $724.44 |
Medica Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $758.58 | Facility | None | $323.59 | $407.38 | $758.58 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $691.83 Typical High $2,089.30 | Professional | None | $257.04 | $691.83 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $645.65 | Professional | None | $512.86 | $512.86 | $645.65 |
Midlands Setting Facility Modifier None Typical Low $537.03 Median $645.65 Typical High $1,000.00 | Facility | None | $537.03 | $645.65 | $1,000.00 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $575.44 | Professional | None | $467.74 | $467.74 | $575.44 |
Sanford Health Plan Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $549.54 | Professional | None | $281.84 | $426.58 | $549.54 |
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 $245.47 Median $467.74 Typical High $794.33 | Professional | None | $245.47 | $467.74 | $794.33 |
Wellmark Setting Professional Modifier None Typical Low $398.11 Median $457.09 Typical High $660.69 | Professional | None | $398.11 | $457.09 | $660.69 |
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 $95.50 Median $120.23 Typical High $154.88 | Professional | 52 · Reduced service | $95.50 | $120.23 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $48.98 Typical High $61.66 | Professional | 53 · Discontinued | $38.02 | $48.98 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $181.97 Typical High $229.09 | Professional | 54 · Surgery only | $144.54 | $181.97 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $36.31 Typical High $46.77 | Professional | 55 · Aftercare only | $28.84 | $36.31 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $23.99 Typical High $30.90 | Professional | 56 · Pre-op care only | $19.05 | $23.99 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $134.90 Median $169.82 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $134.90 | $169.82 | $213.80 |
Where South Dakota sits
The same service costs 3.9 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· 5th of 51
$501
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.