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 $147.91 Median $257.04 Typical High $4,365.16 | Facility | None | $147.91 | $257.04 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $213.80 Typical High $263.03 | Professional | None | $123.03 | $213.80 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $251.19 Typical High $489.78 | Facility | None | $79.43 | $251.19 | $489.78 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $426.58 Typical High $776.25 | Professional | None | $302.00 | $426.58 | $776.25 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $208.93 Typical High $389.05 | Facility | None | $125.89 | $208.93 | $389.05 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $588.84 Typical High $1,949.84 | Professional | None | $218.78 | $588.84 | $1,949.84 |
Midlands Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $562.34 | Professional | None | $346.74 | $346.74 | $562.34 |
Midlands Setting Facility Modifier None Typical Low $79.43 Median $245.47 Typical High $302.00 | Facility | None | $79.43 | $245.47 | $302.00 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $524.81 | Professional | None | $302.00 | $302.00 | $524.81 |
Sanford Health Plan Setting Professional Modifier None Typical Low $194.98 Median $316.23 Typical High $489.78 | Professional | None | $194.98 | $316.23 | $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 $173.78 Median $389.05 Typical High $707.95 | Professional | None | $173.78 | $389.05 | $707.95 |
Wellmark Setting Professional Modifier None Typical Low $257.04 Median $295.12 Typical High $602.56 | Professional | None | $257.04 | $295.12 | $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 $61.66 Median $112.20 Typical High $131.83 | Professional | 52 · Reduced service | $61.66 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $44.67 Typical High $52.48 | Professional | 53 · Discontinued | $24.55 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $169.82 Typical High $194.98 | Professional | 54 · Surgery only | $91.20 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $33.88 Typical High $39.81 | Professional | 55 · Aftercare only | $18.62 | $33.88 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $22.39 Typical High $26.30 | Professional | 56 · Pre-op care only | $12.30 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $158.49 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $85.11 | $158.49 | $181.97 |
Where South Dakota sits
The same service costs 3.4 times more in Alaska than in Maryland. 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
$347
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.