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 $1,412.54 Median $1,412.54 Typical High $1,778.28 | Facility | None | $1,412.54 | $1,412.54 | $1,778.28 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,412.54 Typical High $1,698.24 | Professional | None | $1,096.48 | $1,412.54 | $1,698.24 |
Cigna Setting Facility Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $3,090.30 | Facility | None | $1,096.48 | $1,258.93 | $3,090.30 |
Cigna Setting Professional Modifier None Typical Low $2,754.23 Median $3,548.13 Typical High $4,265.80 | Professional | None | $2,754.23 | $3,548.13 | $4,265.80 |
Medica Setting Facility Modifier None Typical Low $1,862.09 Median $2,398.83 Typical High $3,311.31 | Facility | None | $1,862.09 | $2,398.83 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $1,819.70 Median $4,677.35 Typical High $12,302.69 | Professional | None | $1,819.70 | $4,677.35 | $12,302.69 |
Midlands Setting Professional Modifier None Typical Low $3,467.37 Median $3,467.37 Typical High $4,168.69 | Professional | None | $3,467.37 | $3,467.37 | $4,168.69 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,148.15 Typical High $1,548.82 | Facility | None | $1,096.48 | $1,148.15 | $1,548.82 |
Midlands Setting Professional Modifier None Typical Low $2,951.21 Median $3,467.37 Typical High $4,265.80 | Professional | None | $2,951.21 | $3,467.37 | $4,265.80 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,949.84 Median $2,570.40 Typical High $3,311.31 | Professional | None | $1,949.84 | $2,570.40 | $3,311.31 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,311.31 | Facility | None | $2,818.38 | $2,818.38 | $3,311.31 |
United Setting Professional Modifier None Typical Low $1,584.89 Median $3,630.78 Typical High $4,897.79 | Professional | None | $1,584.89 | $3,630.78 | $4,897.79 |
Wellmark Setting Professional Modifier None Typical Low $2,511.89 Median $2,951.21 Typical High $4,466.84 | Professional | None | $2,511.89 | $2,951.21 | $4,466.84 |
5 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 $549.54 Median $707.95 Typical High $851.14 | Professional | 52 · Reduced service | $549.54 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $223.87 Median $281.84 Typical High $338.84 | Professional | 53 · Discontinued | $223.87 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $165.96 Median $213.80 Typical High $257.04 | Professional | 55 · Aftercare only | $165.96 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $141.25 Typical High $169.82 | Professional | 56 · Pre-op care only | $109.65 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $776.25 Median $977.24 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $776.25 | $977.24 | $1,202.26 |
Where South Dakota sits
The same service costs 5.1 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
$3,162
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.