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 $144.54 Median $371.54 Typical High $4,365.16 | Facility | None | $144.54 | $371.54 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $309.03 Typical High $416.87 | Professional | None | $123.03 | $309.03 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $524.81 Median $812.83 Typical High $1,047.13 | Facility | None | $524.81 | $812.83 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $512.86 Typical High $977.24 | Professional | None | $281.84 | $512.86 | $977.24 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $524.81 Typical High $1,202.26 | Facility | None | $208.93 | $524.81 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $331.13 Median $954.99 Typical High $2,818.38 | Professional | None | $331.13 | $954.99 | $2,818.38 |
Midlands Setting Professional Modifier None Typical Low $331.13 Median $331.13 Typical High $851.14 | Professional | None | $331.13 | $331.13 | $851.14 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $954.99 Typical High $1,202.26 | Facility | None | $645.65 | $954.99 | $1,202.26 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $323.59 Typical High $851.14 | Professional | None | $302.00 | $323.59 | $851.14 |
Sanford Health Plan Setting Professional Modifier None Typical Low $186.21 Median $407.38 Typical High $645.65 | Professional | None | $186.21 | $407.38 | $645.65 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $173.78 Median $407.38 Typical High $1,047.13 | Professional | None | $173.78 | $407.38 | $1,047.13 |
Wellmark Setting Professional Modifier None Typical Low $302.00 Median $354.81 Typical High $954.99 | Professional | None | $302.00 | $354.81 | $954.99 |
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 $61.66 Median $147.91 Typical High $181.97 | Professional | 52 · Reduced service | $61.66 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $24.55 Median $58.88 Typical High $72.44 | Professional | 53 · Discontinued | $24.55 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $93.33 Median $218.78 Typical High $269.15 | Professional | 54 · Surgery only | $93.33 | $218.78 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $43.65 Typical High $53.70 | Professional | 55 · Aftercare only | $18.62 | $43.65 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $29.51 Typical High $36.31 | Professional | 56 · Pre-op care only | $12.30 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $87.10 Median $204.17 Typical High $251.19 | Professional | 78 · Unplanned return to OR | $87.10 | $204.17 | $251.19 |
Where South Dakota sits
The same service costs 4.0 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· 9th of 51
$457
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.