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 $70.79 Median $97.72 Typical High $4,365.16 | Facility | None | $70.79 | $97.72 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $60.26 Median $87.10 Typical High $109.65 | Professional | None | $60.26 | $87.10 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $147.91 Typical High $186.21 | Facility | None | $70.79 | $147.91 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $208.93 Typical High $251.19 | Professional | None | $147.91 | $208.93 | $251.19 |
Medica Setting Facility Modifier None Typical Low $93.33 Median $125.89 Typical High $223.87 | Facility | None | $93.33 | $125.89 | $223.87 |
Medica Setting Professional Modifier None Typical Low $87.10 Median $234.42 Typical High $741.31 | Professional | None | $87.10 | $234.42 | $741.31 |
Midlands Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $218.78 | Professional | None | $162.18 | $162.18 | $218.78 |
Midlands Setting Facility Modifier None Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | None | $70.79 | $70.79 | $70.79 |
Midlands Setting Professional Modifier None Typical Low $144.54 Median $144.54 Typical High $190.55 | Professional | None | $144.54 | $144.54 | $190.55 |
Sanford Health Plan Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $190.55 | Professional | None | $102.33 | $138.04 | $190.55 |
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 $79.43 Median $151.36 Typical High $269.15 | Professional | None | $79.43 | $151.36 | $269.15 |
Wellmark Setting Professional Modifier None Typical Low $117.49 Median $134.90 Typical High $223.87 | Professional | None | $117.49 | $134.90 | $223.87 |
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 $30.20 Median $43.65 Typical High $50.12 | Professional | 52 · Reduced service | $30.20 | $43.65 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $17.38 Typical High $19.95 | Professional | 53 · Discontinued | $12.02 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $45.71 Median $64.57 Typical High $75.86 | Professional | 54 · Surgery only | $45.71 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $12.88 Typical High $15.14 | Professional | 55 · Aftercare only | $9.12 | $12.88 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $8.71 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.03 | $8.71 | $10.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $42.66 Median $60.26 Typical High $70.79 | Professional | 78 · Unplanned return to OR | $42.66 | $60.26 | $70.79 |
Where South Dakota sits
The same service costs 3.8 times more in Alaska than in Kentucky. 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
$162
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.