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 $660.69 Median $794.33 Typical High $4,365.16 | Facility | None | $660.69 | $794.33 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $660.69 Typical High $912.01 | Professional | None | $549.54 | $660.69 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $1,148.15 Median $1,348.96 Typical High $1,445.44 | Facility | None | $1,148.15 | $1,348.96 | $1,445.44 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,737.80 Typical High $1,995.26 | Professional | None | $1,318.26 | $1,737.80 | $1,995.26 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $954.99 Typical High $1,698.24 | Facility | None | $758.58 | $954.99 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $741.31 Median $1,995.26 Typical High $5,888.44 | Professional | None | $741.31 | $1,995.26 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $1,513.56 Median $1,548.82 Typical High $1,819.70 | Professional | None | $1,513.56 | $1,548.82 | $1,819.70 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,288.25 Typical High $1,513.56 | Facility | None | $1,096.48 | $1,288.25 | $1,513.56 |
Midlands Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,380.38 | $1,659.59 |
Sanford Health Plan Setting Professional Modifier None Typical Low $776.25 Median $1,202.26 Typical High $1,513.56 | Professional | None | $776.25 | $1,202.26 | $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 $691.83 Median $1,380.38 Typical High $2,238.72 | Professional | None | $691.83 | $1,380.38 | $2,238.72 |
Wellmark Setting Professional Modifier None Typical Low $1,122.02 Median $1,288.25 Typical High $1,819.70 | Professional | None | $1,122.02 | $1,288.25 | $1,819.70 |
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 $275.42 Median $331.13 Typical High $446.68 | Professional | 52 · Reduced service | $275.42 | $331.13 | $446.68 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $134.90 Typical High $177.83 | Professional | 53 · Discontinued | $109.65 | $134.90 | $177.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $501.19 Typical High $660.69 | Professional | 54 · Surgery only | $407.38 | $501.19 | $660.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $100.00 Typical High $131.83 | Professional | 55 · Aftercare only | $81.28 | $100.00 | $131.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $66.07 Typical High $89.13 | Professional | 56 · Pre-op care only | $54.95 | $66.07 | $89.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $467.74 Typical High $616.60 | Professional | 78 · Unplanned return to OR | $380.19 | $467.74 | $616.60 |
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
$1,380
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.