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 $131.83 Median $208.93 Typical High $4,365.16 | Facility | None | $131.83 | $208.93 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $208.93 | Professional | None | $109.65 | $177.83 | $208.93 |
Cigna Setting Facility Modifier None Typical Low $100.00 Median $199.53 Typical High $389.05 | Facility | None | $100.00 | $199.53 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $380.19 Typical High $616.60 | Professional | None | $275.42 | $380.19 | $616.60 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $199.53 Typical High $302.00 | Facility | None | $125.89 | $199.53 | $302.00 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $501.19 Typical High $1,548.82 | Professional | None | $181.97 | $501.19 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $467.74 | Professional | None | $309.03 | $309.03 | $467.74 |
Midlands Setting Facility Modifier None Typical Low $100.00 Median $194.98 Typical High $213.80 | Facility | None | $100.00 | $194.98 | $213.80 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $416.87 | Professional | None | $275.42 | $275.42 | $416.87 |
Sanford Health Plan Setting Professional Modifier None Typical Low $204.17 Median $275.42 Typical High $407.38 | Professional | None | $204.17 | $275.42 | $407.38 |
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 $158.49 Median $309.03 Typical High $575.44 | Professional | None | $158.49 | $309.03 | $575.44 |
Wellmark Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $467.74 | Professional | None | $218.78 | $251.19 | $467.74 |
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 $54.95 Median $89.13 Typical High $104.71 | Professional | 52 · Reduced service | $54.95 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $35.48 Typical High $41.69 | Professional | 53 · Discontinued | $22.39 | $35.48 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $83.18 Median $134.90 Typical High $154.88 | Professional | 54 · Surgery only | $83.18 | $134.90 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $26.92 Typical High $30.90 | Professional | 55 · Aftercare only | $16.60 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $17.78 Typical High $20.89 | Professional | 56 · Pre-op care only | $10.96 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $77.62 Median $125.89 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $77.62 | $125.89 | $144.54 |
Where South Dakota sits
The same service costs 3.5 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· 5th of 51
$309
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.