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 $158.49 Median $234.42 Typical High $4,365.16 | Facility | None | $158.49 | $234.42 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $239.88 | Professional | None | $128.82 | $204.17 | $239.88 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $218.78 Typical High $436.52 | Facility | None | $173.78 | $218.78 | $436.52 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $691.83 | Professional | None | $316.23 | $446.68 | $691.83 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $223.87 Typical High $354.81 | Facility | None | $125.89 | $223.87 | $354.81 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $575.44 Typical High $1,778.28 | Professional | None | $204.17 | $575.44 | $1,778.28 |
Midlands Setting Professional Modifier None Typical Low $371.54 Median $371.54 Typical High $537.03 | Professional | None | $371.54 | $371.54 | $537.03 |
Midlands Setting Facility Modifier None Typical Low $173.78 Median $213.80 Typical High $234.42 | Facility | None | $173.78 | $213.80 | $234.42 |
Midlands Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $478.63 | Professional | None | $323.59 | $323.59 | $478.63 |
Sanford Health Plan Setting Professional Modifier None Typical Low $234.42 Median $323.59 Typical High $457.09 | Professional | None | $234.42 | $323.59 | $457.09 |
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 $186.21 Median $354.81 Typical High $660.69 | Professional | None | $186.21 | $354.81 | $660.69 |
Wellmark Setting Professional Modifier None Typical Low $251.19 Median $295.12 Typical High $524.81 | Professional | None | $251.19 | $295.12 | $524.81 |
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 $64.57 Median $102.33 Typical High $117.49 | Professional | 52 · Reduced service | $64.57 | $102.33 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $40.74 Typical High $46.77 | Professional | 53 · Discontinued | $25.70 | $40.74 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $151.36 Typical High $177.83 | Professional | 54 · Surgery only | $97.72 | $151.36 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $30.20 Typical High $35.48 | Professional | 55 · Aftercare only | $19.50 | $30.20 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $20.42 Typical High $23.44 | Professional | 56 · Pre-op care only | $12.88 | $20.42 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $91.20 Median $141.25 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $91.20 | $141.25 | $165.96 |
Where South Dakota sits
The same service costs 3.5 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· 5th of 51
$363
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.