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 $851.14 Median $1,000.00 Typical High $4,365.16 | Facility | None | $851.14 | $1,000.00 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $724.44 Median $851.14 Typical High $1,202.26 | Professional | None | $724.44 | $851.14 | $1,202.26 |
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 $1,698.24 Median $2,089.30 Typical High $2,951.21 | Professional | None | $1,698.24 | $2,089.30 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,202.26 Typical High $1,949.84 | Facility | None | $758.58 | $1,202.26 | $1,949.84 |
Medica Setting Professional Modifier None Typical Low $891.25 Median $2,290.87 Typical High $7,413.10 | Professional | None | $891.25 | $2,290.87 | $7,413.10 |
Midlands Setting Professional Modifier None Typical Low $1,905.46 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,905.46 | $1,949.84 | $2,290.87 |
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 $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,737.80 | $1,737.80 | $2,041.74 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,023.29 Median $1,584.89 Typical High $1,949.84 | Professional | None | $1,023.29 | $1,584.89 | $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 $1,778.28 Typical High $2,818.38 | Professional | None | $870.96 | $1,778.28 | $2,818.38 |
Wellmark Setting Professional Modifier None Typical Low $1,445.44 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,445.44 | $1,659.59 | $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 $354.81 Median $426.58 Typical High $575.44 | Professional | 52 · Reduced service | $354.81 | $426.58 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $169.82 Typical High $229.09 | Professional | 53 · Discontinued | $144.54 | $169.82 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $645.65 Typical High $870.96 | Professional | 54 · Surgery only | $537.03 | $645.65 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $128.82 Typical High $173.78 | Professional | 55 · Aftercare only | $107.15 | $128.82 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $85.11 Typical High $114.82 | Professional | 56 · Pre-op care only | $72.44 | $85.11 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $602.56 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $501.19 | $602.56 | $812.83 |
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
$1,698
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.