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 $141.25 Median $208.93 Typical High $4,365.16 | Facility | None | $141.25 | $208.93 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $181.97 Typical High $229.09 | Professional | None | $114.82 | $181.97 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $194.98 Typical High $389.05 | Facility | None | $158.49 | $194.98 | $389.05 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $398.11 Typical High $537.03 | Professional | None | $288.40 | $398.11 | $537.03 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $199.53 Typical High $316.23 | Facility | None | $125.89 | $199.53 | $316.23 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $512.86 Typical High $1,584.89 | Professional | None | $181.97 | $512.86 | $1,584.89 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $478.63 | Professional | None | $331.13 | $331.13 | $478.63 |
Midlands Setting Facility Modifier None Typical Low $158.49 Median $190.55 Typical High $208.93 | Facility | None | $158.49 | $190.55 | $208.93 |
Midlands Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $426.58 | Professional | None | $288.40 | $288.40 | $426.58 |
Sanford Health Plan Setting Professional Modifier None Typical Low $208.93 Median $288.40 Typical High $407.38 | Professional | None | $208.93 | $288.40 | $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 $165.96 Median $316.23 Typical High $588.84 | Professional | None | $165.96 | $316.23 | $588.84 |
Wellmark Setting Professional Modifier None Typical Low $229.09 Median $263.03 Typical High $467.74 | Professional | None | $229.09 | $263.03 | $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 $57.54 Median $91.20 Typical High $104.71 | Professional | 52 · Reduced service | $57.54 | $91.20 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $36.31 Typical High $41.69 | Professional | 53 · Discontinued | $23.44 | $36.31 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $134.90 Typical High $158.49 | Professional | 54 · Surgery only | $87.10 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $26.92 Typical High $31.62 | Professional | 55 · Aftercare only | $17.38 | $26.92 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $18.20 Typical High $20.89 | Professional | 56 · Pre-op care only | $11.48 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $125.89 Typical High $147.91 | Professional | 78 · Unplanned return to OR | $81.28 | $125.89 | $147.91 |
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
$324
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.