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 $169.82 Median $245.47 Typical High $4,365.16 | Facility | None | $169.82 | $245.47 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $263.03 | Professional | None | $141.25 | $208.93 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $177.83 Median $218.78 Typical High $457.09 | Facility | None | $177.83 | $218.78 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $630.96 | Professional | None | $346.74 | $489.78 | $630.96 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $239.88 Typical High $389.05 | Facility | None | $125.89 | $239.88 | $389.05 |
Medica Setting Professional Modifier None Typical Low $218.78 Median $602.56 Typical High $1,819.70 | Professional | None | $218.78 | $602.56 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $562.34 | Professional | None | $407.38 | $407.38 | $562.34 |
Midlands Setting Facility Modifier None Typical Low $177.83 Median $213.80 Typical High $234.42 | Facility | None | $177.83 | $213.80 | $234.42 |
Midlands Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $501.19 | Professional | None | $354.81 | $354.81 | $501.19 |
Sanford Health Plan Setting Professional Modifier None Typical Low $245.47 Median $338.84 Typical High $478.63 | Professional | None | $245.47 | $338.84 | $478.63 |
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 $204.17 Median $371.54 Typical High $691.83 | Professional | None | $204.17 | $371.54 | $691.83 |
Wellmark Setting Professional Modifier None Typical Low $275.42 Median $316.23 Typical High $549.54 | Professional | None | $275.42 | $316.23 | $549.54 |
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 $70.79 Median $104.71 Typical High $123.03 | Professional | 52 · Reduced service | $70.79 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $28.18 Median $42.66 Typical High $48.98 | Professional | 53 · Discontinued | $28.18 | $42.66 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $107.15 Median $158.49 Typical High $186.21 | Professional | 54 · Surgery only | $107.15 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.38 Median $31.62 Typical High $37.15 | Professional | 55 · Aftercare only | $21.38 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.13 Median $20.89 Typical High $24.55 | Professional | 56 · Pre-op care only | $14.13 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $100.00 Median $147.91 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $100.00 | $147.91 | $173.78 |
Where South Dakota sits
The same service costs 3.5 times more in Alaska than in Texas. 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
$389
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.