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 $812.83 Median $1,000.00 Typical High $4,365.16 | Facility | None | $812.83 | $1,000.00 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,122.02 | Professional | None | $691.83 | $851.14 | $1,122.02 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,288.25 Typical High $1,862.09 | Facility | None | $1,023.29 | $1,288.25 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,089.30 Typical High $2,511.89 | Professional | None | $1,659.59 | $2,089.30 | $2,511.89 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,905.46 | Facility | None | $758.58 | $1,202.26 | $1,905.46 |
Medica Setting Professional Modifier None Typical Low $1,047.13 Median $2,290.87 Typical High $7,413.10 | Professional | None | $1,047.13 | $2,290.87 | $7,413.10 |
Midlands Setting Professional Modifier None Typical Low $1,905.46 Median $1,905.46 Typical High $2,290.87 | Professional | None | $1,905.46 | $1,905.46 | $2,290.87 |
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 $1,698.24 Median $1,698.24 Typical High $2,041.74 | Professional | None | $1,698.24 | $1,698.24 | $2,041.74 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,174.90 Median $1,548.82 Typical High $1,949.84 | Professional | None | $1,174.90 | $1,548.82 | $1,949.84 |
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 $870.96 Median $1,737.80 Typical High $2,754.23 | Professional | None | $870.96 | $1,737.80 | $2,754.23 |
Wellmark Setting Professional Modifier None Typical Low $1,380.38 Median $1,621.81 Typical High $2,290.87 | Professional | None | $1,380.38 | $1,621.81 | $2,290.87 |
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 $346.74 Median $426.58 Typical High $562.34 | Professional | 52 · Reduced service | $346.74 | $426.58 | $562.34 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $169.82 Typical High $223.87 | Professional | 53 · Discontinued | $138.04 | $169.82 | $223.87 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $645.65 Typical High $831.76 | Professional | 54 · Surgery only | $524.81 | $645.65 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $128.82 Typical High $165.96 | Professional | 55 · Aftercare only | $104.71 | $128.82 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $85.11 Typical High $112.20 | Professional | 56 · Pre-op care only | $69.18 | $85.11 | $112.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $602.56 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $489.78 | $602.56 | $776.25 |
Where South Dakota sits
The same service costs 4.5 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
$1,698
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.