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 $245.47 Median $851.14 Typical High $4,365.16 | Facility | None | $245.47 | $851.14 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $426.58 | Professional | None | $204.17 | $331.13 | $426.58 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $302.00 Typical High $707.95 | Facility | None | $234.42 | $302.00 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $1,000.00 | Professional | None | $524.81 | $691.83 | $1,000.00 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $346.74 Typical High $562.34 | Facility | None | $125.89 | $346.74 | $562.34 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $954.99 Typical High $2,884.03 | Professional | None | $338.84 | $954.99 | $2,884.03 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $891.25 | Professional | None | $575.44 | $575.44 | $891.25 |
Midlands Setting Facility Modifier None Typical Low $234.42 Median $302.00 Typical High $954.99 | Facility | None | $234.42 | $302.00 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $794.33 | Professional | None | $512.86 | $512.86 | $794.33 |
Sanford Health Plan Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $741.31 | Professional | None | $338.84 | $512.86 | $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 $295.12 Median $575.44 Typical High $1,096.48 | Professional | None | $295.12 | $575.44 | $1,096.48 |
Wellmark Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $891.25 | Professional | None | $407.38 | $467.74 | $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 $102.33 Median $165.96 Typical High $190.55 | Professional | 52 · Reduced service | $102.33 | $165.96 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $66.07 Typical High $77.62 | Professional | 53 · Discontinued | $40.74 | $66.07 | $77.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $251.19 Typical High $288.40 | Professional | 54 · Surgery only | $151.36 | $251.19 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $50.12 Typical High $57.54 | Professional | 55 · Aftercare only | $30.20 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $33.11 Typical High $38.02 | Professional | 56 · Pre-op care only | $20.42 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $234.42 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $141.25 | $234.42 | $269.15 |
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· 4th of 51
$562
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.