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 $151.36 Median $251.19 Typical High $4,365.16 | Facility | None | $151.36 | $251.19 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $295.12 | Professional | None | $128.82 | $218.78 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $199.53 Median $251.19 Typical High $489.78 | Facility | None | $199.53 | $251.19 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $776.25 | Professional | None | $316.23 | $446.68 | $776.25 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $218.78 Typical High $380.19 | Facility | None | $125.89 | $218.78 | $380.19 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $562.34 Typical High $1,949.84 | Professional | None | $218.78 | $562.34 | $1,949.84 |
Midlands Setting Professional Modifier None Typical Low $346.74 Median $354.81 Typical High $562.34 | Professional | None | $346.74 | $354.81 | $562.34 |
Midlands Setting Facility Modifier None Typical Low $199.53 Median $245.47 Typical High $302.00 | Facility | None | $199.53 | $245.47 | $302.00 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $478.63 | Professional | None | $316.23 | $316.23 | $478.63 |
Sanford Health Plan Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $489.78 | Professional | None | $204.17 | $331.13 | $489.78 |
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 $181.97 Median $389.05 Typical High $707.95 | Professional | None | $181.97 | $389.05 | $707.95 |
Wellmark Setting Professional Modifier None Typical Low $263.03 Median $309.03 Typical High $602.56 | Professional | None | $263.03 | $309.03 | $602.56 |
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 $64.57 Median $114.82 Typical High $131.83 | Professional | 52 · Reduced service | $64.57 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $45.71 Typical High $52.48 | Professional | 53 · Discontinued | $25.70 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $169.82 Typical High $194.98 | Professional | 54 · Surgery only | $95.50 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $33.88 Typical High $38.90 | Professional | 55 · Aftercare only | $19.05 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $22.91 Typical High $26.30 | Professional | 56 · Pre-op care only | $12.88 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $158.49 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $89.13 | $158.49 | $181.97 |
Where South Dakota sits
The same service costs 3.5 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
$355
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.