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 $398.11 Median $501.19 Typical High $4,365.16 | Facility | None | $398.11 | $501.19 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $398.11 Typical High $524.81 | Professional | None | $309.03 | $398.11 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $1,445.44 Typical High $1,737.80 | Facility | None | $691.83 | $1,445.44 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,000.00 Typical High $1,230.27 | Professional | None | $776.25 | $1,000.00 | $1,230.27 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $676.08 Typical High $1,698.24 | Facility | None | $524.81 | $676.08 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $1,318.26 Typical High $3,467.37 | Professional | None | $457.09 | $1,318.26 | $3,467.37 |
Midlands Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,174.90 | Professional | None | $933.25 | $933.25 | $1,174.90 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,479.11 Typical High $1,995.26 | Facility | None | $954.99 | $1,479.11 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,174.90 | Professional | None | $812.83 | $933.25 | $1,174.90 |
Sanford Health Plan Setting Professional Modifier None Typical Low $457.09 Median $676.08 Typical High $912.01 | Professional | None | $457.09 | $676.08 | $912.01 |
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 $436.52 Median $1,000.00 Typical High $1,412.54 | Professional | None | $436.52 | $1,000.00 | $1,412.54 |
Wellmark Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,230.27 | Professional | None | $741.31 | $870.96 | $1,230.27 |
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 $154.88 Median $199.53 Typical High $239.88 | Professional | 52 · Reduced service | $154.88 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $79.43 Typical High $95.50 | Professional | 53 · Discontinued | $61.66 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $302.00 Typical High $354.81 | Professional | 54 · Surgery only | $234.42 | $302.00 | $354.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $60.26 Typical High $70.79 | Professional | 55 · Aftercare only | $46.77 | $60.26 | $70.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $39.81 Typical High $47.86 | Professional | 56 · Pre-op care only | $30.90 | $39.81 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $281.84 Typical High $331.13 | Professional | 78 · Unplanned return to OR | $218.78 | $281.84 | $331.13 |
Where South Dakota sits
The same service costs 6.0 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· 3rd of 51
$933
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.