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 $218.78 Median $380.19 Typical High $4,365.16 | Facility | None | $218.78 | $380.19 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $302.00 Typical High $380.19 | Professional | None | $181.97 | $302.00 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $288.40 Typical High $707.95 | Facility | None | $79.43 | $288.40 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $630.96 Typical High $1,000.00 | Professional | None | $446.68 | $630.96 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $309.03 Typical High $549.54 | Facility | None | $125.89 | $309.03 | $549.54 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $891.25 Typical High $2,818.38 | Professional | None | $331.13 | $891.25 | $2,818.38 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $831.76 | Professional | None | $512.86 | $512.86 | $831.76 |
Midlands Setting Facility Modifier None Typical Low $79.43 Median $288.40 Typical High $954.99 | Facility | None | $79.43 | $288.40 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $776.25 | Professional | None | $457.09 | $457.09 | $776.25 |
Sanford Health Plan Setting Professional Modifier None Typical Low $354.81 Median $478.63 Typical High $741.31 | Professional | None | $354.81 | $478.63 | $741.31 |
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 $263.03 Median $562.34 Typical High $1,047.13 | Professional | None | $263.03 | $562.34 | $1,047.13 |
Wellmark Setting Professional Modifier None Typical Low $389.05 Median $457.09 Typical High $891.25 | Professional | None | $389.05 | $457.09 | $891.25 |
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 $91.20 Median $162.18 Typical High $190.55 | Professional | 52 · Reduced service | $91.20 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $66.07 Typical High $75.86 | Professional | 53 · Discontinued | $36.31 | $66.07 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $138.04 Median $245.47 Typical High $281.84 | Professional | 54 · Surgery only | $138.04 | $245.47 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $48.98 Typical High $56.23 | Professional | 55 · Aftercare only | $27.54 | $48.98 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $33.11 Typical High $38.02 | Professional | 56 · Pre-op care only | $18.20 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $128.82 Median $229.09 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $128.82 | $229.09 | $263.03 |
Where South Dakota sits
The same service costs 3.5 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· 7th of 51
$513
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.