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 $114.82 Median $194.98 Typical High $4,365.16 | Facility | None | $114.82 | $194.98 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $158.49 Typical High $218.78 | Professional | None | $93.33 | $158.49 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $275.42 Typical High $371.54 | Facility | None | $79.43 | $275.42 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $323.59 Typical High $436.52 | Professional | None | $229.09 | $323.59 | $436.52 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $186.21 Typical High $269.15 | Facility | None | $125.89 | $186.21 | $269.15 |
Medica Setting Professional Modifier None Typical Low $186.21 Median $467.74 Typical High $1,380.38 | Professional | None | $186.21 | $467.74 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $436.52 | Professional | None | $263.03 | $263.03 | $436.52 |
Midlands Setting Facility Modifier None Typical Low $79.43 Median $186.21 Typical High $398.11 | Facility | None | $79.43 | $186.21 | $398.11 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $398.11 | Professional | None | $239.88 | $239.88 | $398.11 |
Sanford Health Plan Setting Professional Modifier None Typical Low $151.36 Median $245.47 Typical High $354.81 | Professional | None | $151.36 | $245.47 | $354.81 |
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 $134.90 Median $281.84 Typical High $549.54 | Professional | None | $134.90 | $281.84 | $549.54 |
Wellmark Setting Professional Modifier None Typical Low $204.17 Median $239.88 Typical High $426.58 | Professional | None | $204.17 | $239.88 | $426.58 |
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 $46.77 Median $79.43 Typical High $97.72 | Professional | 52 · Reduced service | $46.77 | $79.43 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $31.62 Typical High $38.90 | Professional | 53 · Discontinued | $18.62 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $120.23 Typical High $147.91 | Professional | 54 · Surgery only | $69.18 | $120.23 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $23.99 Typical High $29.51 | Professional | 55 · Aftercare only | $13.80 | $23.99 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $15.85 Typical High $19.50 | Professional | 56 · Pre-op care only | $9.33 | $15.85 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $64.57 Median $112.20 Typical High $138.04 | Professional | 78 · Unplanned return to OR | $64.57 | $112.20 | $138.04 |
Where South Dakota sits
The same service costs 3.5 times more in Alaska than in Florida. 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· 8th of 51
$263
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.