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 $758.58 Median $933.25 Typical High $4,365.16 | Facility | None | $758.58 | $933.25 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $645.65 Median $794.33 Typical High $1,047.13 | Professional | None | $645.65 | $794.33 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,698.24 | Facility | None | $1,023.29 | $1,288.25 | $1,698.24 |
Cigna Setting Professional Modifier None Typical Low $1,548.82 Median $1,949.84 Typical High $2,344.23 | Professional | None | $1,548.82 | $1,949.84 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,778.28 | Facility | None | $758.58 | $1,148.15 | $1,778.28 |
Medica Setting Professional Modifier None Typical Low $954.99 Median $2,344.23 Typical High $6,918.31 | Professional | None | $954.99 | $2,344.23 | $6,918.31 |
Midlands Setting Professional Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,137.96 | Professional | None | $1,778.28 | $1,778.28 | $2,137.96 |
Midlands Setting Facility Modifier None Typical Low $1,023.29 Median $1,096.48 Typical High $1,513.56 | Facility | None | $1,023.29 | $1,096.48 | $1,513.56 |
Midlands Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,584.89 | $1,584.89 | $1,905.46 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,096.48 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,096.48 | $1,445.44 | $1,819.70 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $812.83 Median $1,621.81 Typical High $2,570.40 | Professional | None | $812.83 | $1,621.81 | $2,570.40 |
Wellmark Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,288.25 | $1,513.56 | $2,137.96 |
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 $323.59 Median $398.11 Typical High $524.81 | Professional | 52 · Reduced service | $323.59 | $398.11 | $524.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $128.82 Median $158.49 Typical High $208.93 | Professional | 53 · Discontinued | $128.82 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $478.63 Median $588.84 Typical High $776.25 | Professional | 54 · Surgery only | $478.63 | $588.84 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $97.72 Median $117.49 Typical High $154.88 | Professional | 55 · Aftercare only | $97.72 | $117.49 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $64.57 Median $79.43 Typical High $104.71 | Professional | 56 · Pre-op care only | $64.57 | $79.43 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $446.68 Median $549.54 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $446.68 | $549.54 | $724.44 |
Where South Dakota sits
The same service costs 4.4 times more in Alaska than in Texas. 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
$1,585
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.