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 $275.42 Median $346.74 Typical High $4,365.16 | Facility | None | $275.42 | $346.74 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $234.42 Median $295.12 Typical High $380.19 | Professional | None | $234.42 | $295.12 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $288.40 Typical High $645.65 | Facility | None | $194.98 | $288.40 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $1,023.29 | Professional | None | $575.44 | $724.44 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $398.11 Typical High $645.65 | Facility | None | $125.89 | $398.11 | $645.65 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $851.14 Typical High $2,570.40 | Professional | None | $363.08 | $851.14 | $2,570.40 |
Midlands Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $776.25 | Professional | None | $630.96 | $630.96 | $776.25 |
Midlands Setting Facility Modifier None Typical Low $194.98 Median $281.84 Typical High $338.84 | Facility | None | $194.98 | $281.84 | $338.84 |
Midlands Setting Professional Modifier None Typical Low $562.34 Median $562.34 Typical High $691.83 | Professional | None | $562.34 | $562.34 | $691.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $380.19 Median $524.81 Typical High $676.08 | Professional | None | $380.19 | $524.81 | $676.08 |
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 $295.12 Median $575.44 Typical High $954.99 | Professional | None | $295.12 | $575.44 | $954.99 |
Wellmark Setting Professional Modifier None Typical Low $478.63 Median $549.54 Typical High $776.25 | Professional | None | $478.63 | $549.54 | $776.25 |
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 $117.49 Median $147.91 Typical High $190.55 | Professional | 52 · Reduced service | $117.49 | $147.91 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $58.88 Typical High $75.86 | Professional | 53 · Discontinued | $46.77 | $58.88 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $223.87 Typical High $281.84 | Professional | 54 · Surgery only | $177.83 | $223.87 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $44.67 Typical High $56.23 | Professional | 55 · Aftercare only | $35.48 | $44.67 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $29.51 Typical High $38.02 | Professional | 56 · Pre-op care only | $23.44 | $29.51 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $165.96 Median $208.93 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $165.96 | $208.93 | $263.03 |
Where South Dakota sits
The same service costs 4.7 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· 4th of 51
$589
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.