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 $281.84 Median $389.05 Typical High $4,365.16 | Facility | None | $281.84 | $389.05 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $331.13 Typical High $426.58 | Professional | None | $234.42 | $331.13 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $870.96 Typical High $1,047.13 | Facility | None | $575.44 | $870.96 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $812.83 Typical High $1,148.15 | Professional | None | $575.44 | $812.83 | $1,148.15 |
Medica Setting Facility Modifier None Typical Low $398.11 Median $562.34 Typical High $1,202.26 | Facility | None | $398.11 | $562.34 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $977.24 Typical High $2,884.03 | Professional | None | $363.08 | $977.24 | $2,884.03 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $891.25 | Professional | None | $645.65 | $645.65 | $891.25 |
Midlands Setting Facility Modifier None Typical Low $812.83 Median $954.99 Typical High $1,047.13 | Facility | None | $812.83 | $954.99 | $1,047.13 |
Midlands Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $812.83 | Professional | None | $588.84 | $588.84 | $812.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $758.58 | Professional | None | $407.38 | $549.54 | $758.58 |
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 $331.13 Median $588.84 Typical High $1,096.48 | Professional | None | $331.13 | $588.84 | $1,096.48 |
Wellmark Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $891.25 | Professional | None | $478.63 | $549.54 | $891.25 |
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 $117.49 Median $165.96 Typical High $194.98 | Professional | 52 · Reduced service | $117.49 | $165.96 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $66.07 Typical High $77.62 | Professional | 53 · Discontinued | $46.77 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $251.19 Typical High $295.12 | Professional | 54 · Surgery only | $177.83 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $50.12 Typical High $58.88 | Professional | 55 · Aftercare only | $35.48 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $33.11 Typical High $38.90 | Professional | 56 · Pre-op care only | $23.44 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $234.42 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $165.96 | $234.42 | $275.42 |
Where South Dakota sits
The same service costs 3.9 times more in Alaska than in Utah. 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
$646
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.