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 $407.38 Median $537.03 Typical High $4,365.16 | Facility | None | $407.38 | $537.03 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $457.09 Typical High $575.44 | Professional | None | $354.81 | $457.09 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $457.09 Typical High $1,000.00 | Facility | None | $100.00 | $457.09 | $1,000.00 |
Cigna Setting Professional Modifier None Typical Low $870.96 Median $1,122.02 Typical High $1,584.89 | Professional | None | $870.96 | $1,122.02 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $588.84 Typical High $812.83 | Facility | None | $125.89 | $588.84 | $812.83 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $1,380.38 Typical High $5,128.61 | Professional | None | $524.81 | $1,380.38 | $5,128.61 |
Midlands Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,258.93 | Professional | None | $933.25 | $933.25 | $1,258.93 |
Midlands Setting Facility Modifier None Typical Low $100.00 Median $371.54 Typical High $562.34 | Facility | None | $100.00 | $371.54 | $562.34 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $1,096.48 | Professional | None | $851.14 | $851.14 | $1,096.48 |
Sanford Health Plan Setting Professional Modifier None Typical Low $524.81 Median $812.83 Typical High $1,047.13 | Professional | None | $524.81 | $812.83 | $1,047.13 |
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 $467.74 Median $891.25 Typical High $1,513.56 | Professional | None | $467.74 | $891.25 | $1,513.56 |
Wellmark Setting Professional Modifier None Typical Low $707.95 Median $812.83 Typical High $1,202.26 | Professional | None | $707.95 | $812.83 | $1,202.26 |
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 $177.83 Median $229.09 Typical High $281.84 | Professional | 52 · Reduced service | $177.83 | $229.09 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $91.20 Typical High $112.20 | Professional | 53 · Discontinued | $70.79 | $91.20 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $346.74 Typical High $416.87 | Professional | 54 · Surgery only | $263.03 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $69.18 Typical High $85.11 | Professional | 55 · Aftercare only | $52.48 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $45.71 Typical High $56.23 | Professional | 56 · Pre-op care only | $35.48 | $45.71 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $323.59 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $245.47 | $323.59 | $389.05 |
Where South Dakota sits
The same service costs 5.1 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
$912
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.