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 $199.53 Median $309.03 Typical High $4,365.16 | Facility | None | $199.53 | $309.03 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $269.15 Typical High $363.08 | Professional | None | $169.82 | $269.15 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $229.09 Median $281.84 Typical High $588.84 | Facility | None | $229.09 | $281.84 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $416.87 Median $588.84 Typical High $933.25 | Professional | None | $416.87 | $588.84 | $933.25 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $281.84 Typical High $575.44 | Facility | None | $125.89 | $281.84 | $575.44 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $724.44 Typical High $2,344.23 | Professional | None | $263.03 | $724.44 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $676.08 | Professional | None | $467.74 | $467.74 | $676.08 |
Midlands Setting Facility Modifier None Typical Low $208.93 Median $245.47 Typical High $338.84 | Facility | None | $208.93 | $245.47 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $630.96 | Professional | None | $416.87 | $416.87 | $630.96 |
Sanford Health Plan Setting Professional Modifier None Typical Low $269.15 Median $426.58 Typical High $588.84 | Professional | None | $269.15 | $426.58 | $588.84 |
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 $239.88 Median $478.63 Typical High $851.14 | Professional | None | $239.88 | $478.63 | $851.14 |
Wellmark Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $707.95 | Professional | None | $346.74 | $398.11 | $707.95 |
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 $85.11 Median $134.90 Typical High $158.49 | Professional | 52 · Reduced service | $85.11 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $54.95 Typical High $63.10 | Professional | 53 · Discontinued | $33.88 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $204.17 Typical High $234.42 | Professional | 54 · Surgery only | $125.89 | $204.17 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $40.74 Typical High $46.77 | Professional | 55 · Aftercare only | $25.12 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $26.92 Typical High $31.62 | Professional | 56 · Pre-op care only | $16.98 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $190.55 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $117.49 | $190.55 | $218.78 |
Where South Dakota sits
The same service costs 3.7 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
$468
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.