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 $616.60 Median $812.83 Typical High $4,897.79 | Facility | None | $616.60 | $812.83 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $691.83 Typical High $851.14 | Professional | None | $512.86 | $691.83 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $3,019.95 Typical High $3,801.89 | Facility | None | $1,174.90 | $3,019.95 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,737.80 Typical High $2,344.23 | Professional | None | $1,288.25 | $1,737.80 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $870.96 Median $1,148.15 Typical High $3,019.95 | Facility | None | $870.96 | $1,148.15 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,949.84 Typical High $10,000.00 | Professional | None | $758.58 | $1,949.84 | $10,000.00 |
Midlands Setting Professional Modifier None Typical Low $1,548.82 Median $1,548.82 Typical High $2,041.74 | Professional | None | $1,548.82 | $1,548.82 | $2,041.74 |
Midlands Setting Facility Modifier None Typical Low $1,380.38 Median $3,019.95 Typical High $4,073.80 | Facility | None | $1,380.38 | $3,019.95 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $1,258.93 Median $1,380.38 Typical High $1,819.70 | Professional | None | $1,258.93 | $1,380.38 | $1,819.70 |
Sanford Health Plan Setting Professional Modifier None Typical Low $776.25 Median $1,148.15 Typical High $1,548.82 | Professional | None | $776.25 | $1,148.15 | $1,548.82 |
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 $691.83 Median $1,584.89 Typical High $2,290.87 | Professional | None | $691.83 | $1,584.89 | $2,290.87 |
Wellmark Setting Professional Modifier None Typical Low $1,202.26 Median $1,412.54 Typical High $2,041.74 | Professional | None | $1,202.26 | $1,412.54 | $2,041.74 |
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 $257.04 Median $338.84 Typical High $398.11 | Professional | 52 · Reduced service | $257.04 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $138.04 Typical High $162.18 | Professional | 53 · Discontinued | $104.71 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $389.05 Median $512.86 Typical High $602.56 | Professional | 54 · Surgery only | $389.05 | $512.86 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $102.33 Typical High $120.23 | Professional | 55 · Aftercare only | $77.62 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $69.18 Typical High $81.28 | Professional | 56 · Pre-op care only | $51.29 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $363.08 Median $478.63 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $363.08 | $478.63 | $562.34 |
Where South Dakota sits
The same service costs 6.2 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· 5th of 51
$1,479
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.