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 $169.82 Median $275.42 Typical High $4,365.16 | Facility | None | $169.82 | $275.42 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $144.54 Median $234.42 Typical High $281.84 | Professional | None | $144.54 | $234.42 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $269.15 Typical High $524.81 | Facility | None | $208.93 | $269.15 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $354.81 Median $489.78 Typical High $676.08 | Professional | None | $354.81 | $489.78 | $676.08 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $239.88 Typical High $416.87 | Facility | None | $125.89 | $239.88 | $416.87 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $602.56 Typical High $2,089.30 | Professional | None | $239.88 | $602.56 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $602.56 | Professional | None | $389.05 | $389.05 | $602.56 |
Midlands Setting Facility Modifier None Typical Low $208.93 Median $245.47 Typical High $316.23 | Facility | None | $208.93 | $245.47 | $316.23 |
Midlands Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $562.34 | Professional | None | $346.74 | $346.74 | $562.34 |
Sanford Health Plan Setting Professional Modifier None Typical Low $229.09 Median $371.54 Typical High $524.81 | Professional | None | $229.09 | $371.54 | $524.81 |
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 $204.17 Median $426.58 Typical High $758.58 | Professional | None | $204.17 | $426.58 | $758.58 |
Wellmark Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $645.65 | Professional | None | $295.12 | $338.84 | $645.65 |
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 $70.79 Median $123.03 Typical High $141.25 | Professional | 52 · Reduced service | $70.79 | $123.03 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.84 Median $48.98 Typical High $56.23 | Professional | 53 · Discontinued | $28.84 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $181.97 Typical High $208.93 | Professional | 54 · Surgery only | $107.15 | $181.97 | $208.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $36.31 Typical High $42.66 | Professional | 55 · Aftercare only | $21.38 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.45 Median $24.55 Typical High $28.18 | Professional | 56 · Pre-op care only | $14.45 | $24.55 | $28.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $169.82 Typical High $194.98 | Professional | 78 · Unplanned return to OR | $100.00 | $169.82 | $194.98 |
Where South Dakota sits
The same service costs 3.4 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
$389
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.