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 $1,122.02 Median $1,122.02 Typical High $1,412.54 | Facility | None | $1,122.02 | $1,122.02 | $1,412.54 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $1,148.15 Typical High $1,412.54 | Professional | None | $870.96 | $1,148.15 | $1,412.54 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,122.02 Typical High $2,570.40 | Facility | None | $977.24 | $1,122.02 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $2,187.76 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,187.76 | $2,884.03 | $3,548.13 |
Medica Setting Facility Modifier None Typical Low $1,479.11 Median $1,949.84 Typical High $3,311.31 | Facility | None | $1,479.11 | $1,949.84 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $1,445.44 Median $3,801.89 Typical High $10,232.93 | Professional | None | $1,445.44 | $3,801.89 | $10,232.93 |
Midlands Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $3,388.44 | Professional | None | $2,691.53 | $2,691.53 | $3,388.44 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,047.13 Typical High $1,380.38 | Facility | None | $954.99 | $1,047.13 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $2,290.87 Median $2,754.23 Typical High $3,548.13 | Professional | None | $2,290.87 | $2,754.23 | $3,548.13 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,513.56 Median $2,041.74 Typical High $2,691.53 | Professional | None | $1,513.56 | $2,041.74 | $2,691.53 |
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 $1,230.27 Median $2,951.21 Typical High $3,981.07 | Professional | None | $1,230.27 | $2,951.21 | $3,981.07 |
Wellmark Setting Professional Modifier None Typical Low $1,995.26 Median $2,344.23 Typical High $3,630.78 | Professional | None | $1,995.26 | $2,344.23 | $3,630.78 |
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 $436.52 Median $575.44 Typical High $707.95 | Professional | 52 · Reduced service | $436.52 | $575.44 | $707.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $234.42 Typical High $281.84 | Professional | 53 · Discontinued | $173.78 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $173.78 Typical High $208.93 | Professional | 55 · Aftercare only | $128.82 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $114.82 Typical High $141.25 | Professional | 56 · Pre-op care only | $87.10 | $114.82 | $141.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $812.83 Typical High $977.24 | Professional | 78 · Unplanned return to OR | $602.56 | $812.83 | $977.24 |
Where South Dakota sits
The same service costs 5.0 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· 4th of 51
$2,630
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.