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 $257.04 Median $363.08 Typical High $4,365.16 | Facility | None | $257.04 | $363.08 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $295.12 Typical High $446.68 | Professional | None | $223.87 | $295.12 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $380.19 Typical High $691.83 | Facility | None | $295.12 | $380.19 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $676.08 Typical High $954.99 | Professional | None | $501.19 | $676.08 | $954.99 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $457.09 Typical High $758.58 | Facility | None | $371.54 | $457.09 | $758.58 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $870.96 Typical High $2,754.23 | Professional | None | $338.84 | $870.96 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $588.84 Median $588.84 Typical High $794.33 | Professional | None | $588.84 | $588.84 | $794.33 |
Midlands Setting Facility Modifier None Typical Low $295.12 Median $380.19 Typical High $457.09 | Facility | None | $295.12 | $380.19 | $457.09 |
Midlands Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $776.25 | Professional | None | $537.03 | $575.44 | $776.25 |
Sanford Health Plan Setting Professional Modifier None Typical Low $389.05 Median $524.81 Typical High $707.95 | Professional | None | $389.05 | $524.81 | $707.95 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $302.00 Median $676.08 Typical High $1,023.29 | Professional | None | $302.00 | $676.08 | $1,023.29 |
Wellmark Setting Professional Modifier None Typical Low $537.03 Median $645.65 Typical High $1,000.00 | Professional | None | $537.03 | $645.65 | $1,000.00 |
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 $112.20 Median $162.18 Typical High $190.55 | Professional | 52 · Reduced service | $112.20 | $162.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $64.57 Typical High $75.86 | Professional | 53 · Discontinued | $44.67 | $64.57 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $239.88 Typical High $288.40 | Professional | 54 · Surgery only | $165.96 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $33.11 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $32.36 Typical High $38.02 | Professional | 56 · Pre-op care only | $22.39 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $154.88 Median $223.87 Typical High $269.15 | Professional | 78 · Unplanned return to OR | $154.88 | $223.87 | $269.15 |
Where South Dakota sits
The same service costs 4.5 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· 6th of 51
$617
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.