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 $1,380.38 Median $1,380.38 Typical High $1,698.24 | Facility | None | $1,380.38 | $1,380.38 | $1,698.24 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,348.96 Typical High $1,621.81 | Professional | None | $1,071.52 | $1,348.96 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,202.26 Typical High $2,951.21 | Facility | None | $977.24 | $1,202.26 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $3,467.37 Typical High $4,073.80 | Professional | None | $2,630.27 | $3,467.37 | $4,073.80 |
Medica Setting Facility Modifier None Typical Low $1,819.70 Median $2,238.72 Typical High $3,311.31 | Facility | None | $1,819.70 | $2,238.72 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $1,737.80 Median $4,466.84 Typical High $11,748.98 | Professional | None | $1,737.80 | $4,466.84 | $11,748.98 |
Midlands Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $4,073.80 | Professional | None | $3,388.44 | $3,388.44 | $4,073.80 |
Midlands Setting Facility Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,479.11 | Facility | None | $977.24 | $1,096.48 | $1,479.11 |
Midlands Setting Professional Modifier None Typical Low $2,818.38 Median $3,388.44 Typical High $4,073.80 | Professional | None | $2,818.38 | $3,388.44 | $4,073.80 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,862.09 Median $2,511.89 Typical High $3,235.94 | Professional | None | $1,862.09 | $2,511.89 | $3,235.94 |
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 $1,548.82 Median $3,630.78 Typical High $4,677.35 | Professional | None | $1,548.82 | $3,630.78 | $4,677.35 |
Wellmark Setting Professional Modifier None Typical Low $2,454.71 Median $2,884.03 Typical High $4,168.69 | Professional | None | $2,454.71 | $2,884.03 | $4,168.69 |
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 $537.03 Median $676.08 Typical High $812.83 | Professional | 52 · Reduced service | $537.03 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $269.15 Typical High $323.59 | Professional | 53 · Discontinued | $213.80 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $199.53 Typical High $239.88 | Professional | 55 · Aftercare only | $162.18 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $134.90 Typical High $162.18 | Professional | 56 · Pre-op care only | $107.15 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $933.25 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $758.58 | $933.25 | $1,122.02 |
Where South Dakota sits
The same service costs 5.5 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
$3,020
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.