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 $134.90 Median $245.47 Typical High $4,365.16 | Facility | None | $134.90 | $245.47 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $199.53 Typical High $229.09 | Professional | None | $114.82 | $199.53 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $338.84 Typical High $426.58 | Facility | None | $66.07 | $338.84 | $426.58 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $398.11 Typical High $676.08 | Professional | None | $295.12 | $398.11 | $676.08 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $194.98 Typical High $331.13 | Facility | None | $125.89 | $194.98 | $331.13 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $616.60 Typical High $1,698.24 | Professional | None | $218.78 | $616.60 | $1,698.24 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $562.34 | Professional | None | $316.23 | $316.23 | $562.34 |
Midlands Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $66.07 | Facility | None | $66.07 | $66.07 | $66.07 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $501.19 | Professional | None | $275.42 | $275.42 | $501.19 |
Sanford Health Plan Setting Professional Modifier None Typical Low $181.97 Median $295.12 Typical High $446.68 | Professional | None | $181.97 | $295.12 | $446.68 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $162.18 Median $346.74 Typical High $676.08 | Professional | None | $162.18 | $346.74 | $676.08 |
Wellmark Setting Professional Modifier None Typical Low $234.42 Median $275.42 Typical High $537.03 | Professional | None | $234.42 | $275.42 | $537.03 |
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 $57.54 Median $100.00 Typical High $114.82 | Professional | 52 · Reduced service | $57.54 | $100.00 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $39.81 Typical High $45.71 | Professional | 53 · Discontinued | $22.91 | $39.81 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $147.91 Typical High $169.82 | Professional | 54 · Surgery only | $85.11 | $147.91 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $29.51 Typical High $34.67 | Professional | 55 · Aftercare only | $16.98 | $29.51 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $19.95 Typical High $22.91 | Professional | 56 · Pre-op care only | $11.48 | $19.95 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $138.04 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $79.43 | $138.04 | $158.49 |
Where South Dakota sits
The same service costs 3.8 times more in Alaska than in Maryland. 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
$316
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.