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 $724.44 Median $870.96 Typical High $4,365.16 | Facility | None | $724.44 | $870.96 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $602.56 Median $741.31 Typical High $977.24 | Professional | None | $602.56 | $741.31 | $977.24 |
Cigna Setting Facility Modifier None Typical Low $1,047.13 Median $1,318.26 Typical High $1,621.81 | Facility | None | $1,047.13 | $1,318.26 | $1,621.81 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,819.70 Typical High $2,187.76 | Professional | None | $1,445.44 | $1,819.70 | $2,187.76 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,023.29 Typical High $1,698.24 | Facility | None | $758.58 | $1,023.29 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $2,089.30 Typical High $6,456.54 | Professional | None | $758.58 | $2,089.30 | $6,456.54 |
Midlands Setting Professional Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,949.84 | Professional | None | $1,621.81 | $1,621.81 | $1,949.84 |
Midlands Setting Facility Modifier None Typical Low $1,047.13 Median $1,621.81 Typical High $1,995.26 | Facility | None | $1,047.13 | $1,621.81 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,348.96 | $1,659.59 |
Sanford Health Plan Setting Professional Modifier None Typical Low $870.96 Median $1,348.96 Typical High $1,698.24 | Professional | None | $870.96 | $1,348.96 | $1,698.24 |
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 $724.44 Median $1,479.11 Typical High $2,398.83 | Professional | None | $724.44 | $1,479.11 | $2,398.83 |
Wellmark Setting Professional Modifier None Typical Low $1,318.26 Median $1,513.56 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,513.56 | $2,137.96 |
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 $302.00 Median $363.08 Typical High $489.78 | Professional | 52 · Reduced service | $302.00 | $363.08 | $489.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $147.91 Typical High $194.98 | Professional | 53 · Discontinued | $120.23 | $147.91 | $194.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $549.54 Typical High $724.44 | Professional | 54 · Surgery only | $446.68 | $549.54 | $724.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $109.65 Typical High $144.54 | Professional | 55 · Aftercare only | $89.13 | $109.65 | $144.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $74.13 Typical High $97.72 | Professional | 56 · Pre-op care only | $60.26 | $74.13 | $97.72 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $512.86 Typical High $676.08 | Professional | 78 · Unplanned return to OR | $416.87 | $512.86 | $676.08 |
Where South Dakota sits
The same service costs 4.9 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· 5th of 51
$1,549
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.