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 $251.19 Median $407.38 Typical High $4,365.16 | Facility | None | $251.19 | $407.38 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $208.93 Median $338.84 Typical High $407.38 | Professional | None | $208.93 | $338.84 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $363.08 Median $457.09 Typical High $724.44 | Facility | None | $363.08 | $457.09 | $724.44 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $724.44 Typical High $1,174.90 | Professional | None | $512.86 | $724.44 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $354.81 Typical High $575.44 | Facility | None | $125.89 | $354.81 | $575.44 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $912.01 Typical High $2,951.21 | Professional | None | $354.81 | $912.01 | $2,951.21 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $912.01 | Professional | None | $575.44 | $575.44 | $912.01 |
Midlands Setting Facility Modifier None Typical Low $363.08 Median $457.09 Typical High $1,096.48 | Facility | None | $363.08 | $457.09 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $831.76 | Professional | None | $512.86 | $512.86 | $831.76 |
Sanford Health Plan Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $758.58 | Professional | None | $346.74 | $524.81 | $758.58 |
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 $295.12 Median $588.84 Typical High $1,122.02 | Professional | None | $295.12 | $588.84 | $1,122.02 |
Wellmark Setting Professional Modifier None Typical Low $416.87 Median $478.63 Typical High $891.25 | Professional | None | $416.87 | $478.63 | $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 $104.71 Median $169.82 Typical High $194.98 | Professional | 52 · Reduced service | $104.71 | $169.82 | $194.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $41.69 Median $67.61 Typical High $79.43 | Professional | 53 · Discontinued | $41.69 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $154.88 Median $257.04 Typical High $295.12 | Professional | 54 · Surgery only | $154.88 | $257.04 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.90 Median $51.29 Typical High $58.88 | Professional | 55 · Aftercare only | $30.90 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.89 Median $33.88 Typical High $38.90 | Professional | 56 · Pre-op care only | $20.89 | $33.88 | $38.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $144.54 Median $239.88 Typical High $275.42 | Professional | 78 · Unplanned return to OR | $144.54 | $239.88 | $275.42 |
Where South Dakota sits
The same service costs 3.3 times more in Alaska than in Utah. 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· 6th of 51
$575
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.