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 $102.33 Median $158.49 Typical High $4,365.16 | Facility | None | $102.33 | $158.49 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $138.04 Typical High $213.80 | Professional | None | $87.10 | $138.04 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $147.91 Median $162.18 Typical High $302.00 | Facility | None | $147.91 | $162.18 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $302.00 Typical High $478.63 | Professional | None | $213.80 | $302.00 | $478.63 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $199.53 Typical High $380.19 | Facility | None | $125.89 | $199.53 | $380.19 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $380.19 Typical High $1,202.26 | Professional | None | $169.82 | $380.19 | $1,202.26 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $354.81 | Professional | None | $239.88 | $239.88 | $354.81 |
Midlands Setting Facility Modifier None Typical Low $138.04 Median $162.18 Typical High $199.53 | Facility | None | $138.04 | $162.18 | $199.53 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $323.59 | Professional | None | $208.93 | $208.93 | $323.59 |
Sanford Health Plan Setting Professional Modifier None Typical Low $158.49 Median $223.87 Typical High $331.13 | Professional | None | $158.49 | $223.87 | $331.13 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $131.83 Median $239.88 Typical High $446.68 | Professional | None | $131.83 | $239.88 | $446.68 |
Wellmark Setting Professional Modifier None Typical Low $186.21 Median $213.80 Typical High $363.08 | Professional | None | $186.21 | $213.80 | $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 $43.65 Median $69.18 Typical High $81.28 | Professional | 52 · Reduced service | $43.65 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $28.18 Typical High $33.11 | Professional | 53 · Discontinued | $17.38 | $28.18 | $33.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $104.71 Typical High $123.03 | Professional | 54 · Surgery only | $66.07 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $20.89 Typical High $24.55 | Professional | 55 · Aftercare only | $13.18 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $13.80 Typical High $16.60 | Professional | 56 · Pre-op care only | $8.71 | $13.80 | $16.60 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $61.66 Median $97.72 Typical High $114.82 | Professional | 78 · Unplanned return to OR | $61.66 | $97.72 | $114.82 |
Where South Dakota sits
The same service costs 3.2 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· 9th of 51
$240
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.