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 $125.89 Median $194.98 Typical High $4,365.16 | Facility | None | $125.89 | $194.98 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $104.71 Median $165.96 Typical High $213.80 | Professional | None | $104.71 | $165.96 | $213.80 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $288.40 Typical High $363.08 | Facility | None | $100.00 | $288.40 | $363.08 |
Cigna Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $575.44 | Professional | None | $257.04 | $354.81 | $575.44 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $173.78 Typical High $281.84 | Facility | None | $125.89 | $173.78 | $281.84 |
Medica Setting Professional Modifier None Typical Low $169.82 Median $467.74 Typical High $1,445.44 | Professional | None | $169.82 | $467.74 | $1,445.44 |
Midlands Setting Professional Modifier None Typical Low $295.12 Median $295.12 Typical High $436.52 | Professional | None | $295.12 | $295.12 | $436.52 |
Midlands Setting Facility Modifier None Typical Low $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $257.04 Typical High $389.05 | Professional | None | $257.04 | $257.04 | $389.05 |
Sanford Health Plan Setting Professional Modifier None Typical Low $190.55 Median $257.04 Typical High $371.54 | Professional | None | $190.55 | $257.04 | $371.54 |
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 $147.91 Median $288.40 Typical High $537.03 | Professional | None | $147.91 | $288.40 | $537.03 |
Wellmark Setting Professional Modifier None Typical Low $204.17 Median $234.42 Typical High $436.52 | Professional | None | $204.17 | $234.42 | $436.52 |
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 $52.48 Median $83.18 Typical High $97.72 | Professional | 52 · Reduced service | $52.48 | $83.18 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $33.11 Typical High $38.90 | Professional | 53 · Discontinued | $20.89 | $33.11 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $77.62 Median $125.89 Typical High $144.54 | Professional | 54 · Surgery only | $77.62 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.49 Median $25.12 Typical High $28.84 | Professional | 55 · Aftercare only | $15.49 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $16.60 Typical High $19.50 | Professional | 56 · Pre-op care only | $10.47 | $16.60 | $19.50 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $72.44 Median $117.49 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $72.44 | $117.49 | $134.90 |
Where South Dakota sits
The same service costs 3.3 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· 4th of 51
$288
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.