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 $275.42 Median $398.11 Typical High $4,365.16 | Facility | None | $275.42 | $398.11 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $223.87 Median $323.59 Typical High $389.05 | Professional | None | $223.87 | $323.59 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $407.38 Typical High $707.95 | Facility | None | $346.74 | $407.38 | $707.95 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $776.25 Typical High $1,122.02 | Professional | None | $549.54 | $776.25 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $549.54 Typical High $1,698.24 | Facility | None | $380.19 | $549.54 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $1,000.00 Typical High $2,754.23 | Professional | None | $363.08 | $1,000.00 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $912.01 | Professional | None | $645.65 | $645.65 | $912.01 |
Midlands Setting Facility Modifier None Typical Low $346.74 Median $371.54 Typical High $457.09 | Facility | None | $346.74 | $371.54 | $457.09 |
Midlands Setting Professional Modifier None Typical Low $562.34 Median $660.69 Typical High $912.01 | Professional | None | $562.34 | $660.69 | $912.01 |
Sanford Health Plan Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $691.83 | Professional | None | $389.05 | $512.86 | $691.83 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,513.56 | $1,513.56 | $1,819.70 |
United Setting Professional Modifier None Typical Low $323.59 Median $741.31 Typical High $1,096.48 | Professional | None | $323.59 | $741.31 | $1,096.48 |
Wellmark Setting Professional Modifier None Typical Low $524.81 Median $616.60 Typical High $977.24 | Professional | None | $524.81 | $616.60 | $977.24 |
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 $77.62 | Professional | 53 · Discontinued | $44.67 | $64.57 | $77.62 |
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 $33.88 Median $47.86 Typical High $57.54 | Professional | 55 · Aftercare only | $33.88 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.39 Median $32.36 Typical High $38.90 | Professional | 56 · Pre-op care only | $22.39 | $32.36 | $38.90 |
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 5.2 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
$646
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.