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 $616.60 Median $776.25 Typical High $4,365.16 | Facility | None | $616.60 | $776.25 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $660.69 Typical High $831.76 | Professional | None | $512.86 | $660.69 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $1,148.15 Typical High $1,412.54 | Facility | None | $1,023.29 | $1,148.15 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,621.81 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,621.81 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $933.25 Typical High $1,621.81 | Facility | None | $758.58 | $933.25 | $1,621.81 |
Medica Setting Professional Modifier None Typical Low $707.95 Median $1,905.46 Typical High $5,754.40 | Professional | None | $707.95 | $1,905.46 | $5,754.40 |
Midlands Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,737.80 | Professional | None | $1,412.54 | $1,412.54 | $1,737.80 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,023.29 Typical High $1,513.56 | Facility | None | $954.99 | $1,023.29 | $1,513.56 |
Midlands Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,584.89 | Professional | None | $1,258.93 | $1,258.93 | $1,584.89 |
Sanford Health Plan Setting Professional Modifier None Typical Low $758.58 Median $1,148.15 Typical High $1,513.56 | Professional | None | $758.58 | $1,148.15 | $1,513.56 |
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 $660.69 Median $1,288.25 Typical High $2,137.96 | Professional | None | $660.69 | $1,288.25 | $2,137.96 |
Wellmark Setting Professional Modifier None Typical Low $1,071.52 Median $1,230.27 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,230.27 | $1,778.28 |
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 $257.04 Median $331.13 Typical High $416.87 | Professional | 52 · Reduced service | $257.04 | $331.13 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $131.83 Typical High $165.96 | Professional | 53 · Discontinued | $102.33 | $131.83 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $489.78 Typical High $616.60 | Professional | 54 · Surgery only | $389.05 | $489.78 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $97.72 Typical High $123.03 | Professional | 55 · Aftercare only | $77.62 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $66.07 Typical High $83.18 | Professional | 56 · Pre-op care only | $51.29 | $66.07 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $457.09 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $363.08 | $457.09 | $575.44 |
Where South Dakota sits
The same service costs 4.2 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· 7th of 51
$1,288
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.