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 $213.80 Median $316.23 Typical High $4,365.16 | Facility | None | $213.80 | $316.23 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $269.15 Typical High $354.81 | Professional | None | $177.83 | $269.15 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $537.03 Typical High $870.96 | Facility | None | $457.09 | $537.03 | $870.96 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $616.60 Typical High $912.01 | Professional | None | $446.68 | $616.60 | $912.01 |
Medica Setting Facility Modifier None Typical Low $302.00 Median $446.68 Typical High $758.58 | Facility | None | $302.00 | $446.68 | $758.58 |
Medica Setting Professional Modifier None Typical Low $275.42 Median $776.25 Typical High $2,290.87 | Professional | None | $275.42 | $776.25 | $2,290.87 |
Midlands Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $707.95 | Professional | None | $489.78 | $489.78 | $707.95 |
Midlands Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $954.99 | Facility | None | $446.68 | $537.03 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $446.68 Median $446.68 Typical High $645.65 | Professional | None | $446.68 | $446.68 | $645.65 |
Sanford Health Plan Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $602.56 | Professional | None | $302.00 | $426.58 | $602.56 |
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 $257.04 Median $467.74 Typical High $870.96 | Professional | None | $257.04 | $467.74 | $870.96 |
Wellmark Setting Professional Modifier None Typical Low $363.08 Median $416.87 Typical High $707.95 | Professional | None | $363.08 | $416.87 | $707.95 |
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 $89.13 Median $131.83 Typical High $158.49 | Professional | 52 · Reduced service | $89.13 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $53.70 Typical High $63.10 | Professional | 53 · Discontinued | $35.48 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $199.53 Typical High $234.42 | Professional | 54 · Surgery only | $134.90 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $39.81 Typical High $46.77 | Professional | 55 · Aftercare only | $26.92 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $26.92 Typical High $31.62 | Professional | 56 · Pre-op care only | $17.78 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $186.21 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $125.89 | $186.21 | $218.78 |
Where South Dakota sits
The same service costs 3.6 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· 5th of 51
$490
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.