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 $208.93 Median $302.00 Typical High $4,365.16 | Facility | None | $208.93 | $302.00 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $251.19 Typical High $354.81 | Professional | None | $177.83 | $251.19 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $269.15 Typical High $549.54 | Facility | None | $223.87 | $269.15 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $602.56 Typical High $870.96 | Professional | None | $426.58 | $602.56 | $870.96 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $426.58 Typical High $758.58 | Facility | None | $295.12 | $426.58 | $758.58 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $741.31 Typical High $2,187.76 | Professional | None | $263.03 | $741.31 | $2,187.76 |
Midlands Setting Professional Modifier None Typical Low $489.78 Median $489.78 Typical High $676.08 | Professional | None | $489.78 | $489.78 | $676.08 |
Midlands Setting Facility Modifier None Typical Low $223.87 Median $269.15 Typical High $295.12 | Facility | None | $223.87 | $269.15 | $295.12 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $616.60 | Professional | None | $436.52 | $436.52 | $616.60 |
Sanford Health Plan Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $575.44 | Professional | None | $302.00 | $407.38 | $575.44 |
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 $251.19 Median $446.68 Typical High $831.76 | Professional | None | $251.19 | $446.68 | $831.76 |
Wellmark Setting Professional Modifier None Typical Low $354.81 Median $407.38 Typical High $676.08 | Professional | None | $354.81 | $407.38 | $676.08 |
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 $87.10 Median $125.89 Typical High $151.36 | Professional | 52 · Reduced service | $87.10 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $51.29 Typical High $60.26 | Professional | 53 · Discontinued | $35.48 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $190.55 Typical High $223.87 | Professional | 54 · Surgery only | $131.83 | $190.55 | $223.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $38.02 Typical High $44.67 | Professional | 55 · Aftercare only | $26.30 | $38.02 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.38 Median $25.12 Typical High $30.20 | Professional | 56 · Pre-op care only | $17.38 | $25.12 | $30.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $177.83 Typical High $208.93 | Professional | 78 · Unplanned return to OR | $123.03 | $177.83 | $208.93 |
Where South Dakota sits
The same service costs 3.9 times more in Alaska than in Texas. 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
$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.