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 $120.23 Median $177.83 Typical High $4,365.16 | Facility | None | $120.23 | $177.83 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $154.88 Typical High $181.97 | Professional | None | $100.00 | $154.88 | $181.97 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $169.82 Typical High $338.84 | Facility | None | $138.04 | $169.82 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $457.09 | Professional | None | $245.47 | $346.74 | $457.09 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $169.82 Typical High $281.84 | Facility | None | $125.89 | $169.82 | $281.84 |
Medica Setting Professional Modifier None Typical Low $154.88 Median $436.52 Typical High $1,348.96 | Professional | None | $154.88 | $436.52 | $1,348.96 |
Midlands Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $407.38 | Professional | None | $281.84 | $281.84 | $407.38 |
Midlands Setting Facility Modifier None Typical Low $138.04 Median $165.96 Typical High $177.83 | Facility | None | $138.04 | $165.96 | $177.83 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $363.08 | Professional | None | $245.47 | $245.47 | $363.08 |
Sanford Health Plan Setting Professional Modifier None Typical Low $177.83 Median $245.47 Typical High $346.74 | Professional | None | $177.83 | $245.47 | $346.74 |
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 $144.54 Median $269.15 Typical High $501.19 | Professional | None | $144.54 | $269.15 | $501.19 |
Wellmark Setting Professional Modifier None Typical Low $199.53 Median $229.09 Typical High $398.11 | Professional | None | $199.53 | $229.09 | $398.11 |
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 $50.12 Median $77.62 Typical High $91.20 | Professional | 52 · Reduced service | $50.12 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $30.90 Typical High $36.31 | Professional | 53 · Discontinued | $19.95 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $75.86 Median $117.49 Typical High $134.90 | Professional | 54 · Surgery only | $75.86 | $117.49 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $23.44 Typical High $26.92 | Professional | 55 · Aftercare only | $15.14 | $23.44 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $15.49 Typical High $18.20 | Professional | 56 · Pre-op care only | $10.00 | $15.49 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $70.79 Median $109.65 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $70.79 | $109.65 | $125.89 |
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· 4th of 51
$275
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.