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 $630.96 Median $776.25 Typical High $6,918.31 | Facility | None | $630.96 | $776.25 | $6,918.31 |
Aetna Setting Professional Modifier None Typical Low $549.54 Median $691.83 Typical High $812.83 | Professional | None | $549.54 | $691.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $1,174.90 Typical High $1,659.59 | Facility | None | $851.14 | $1,174.90 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,513.56 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,513.56 | $1,995.26 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,000.00 Typical High $1,659.59 | Facility | None | $758.58 | $1,000.00 | $1,659.59 |
Medica Setting Professional Modifier None Typical Low $758.58 Median $1,995.26 Typical High $6,760.83 | Professional | None | $758.58 | $1,995.26 | $6,760.83 |
Midlands Setting Professional Modifier None Typical Low $1,445.44 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,445.44 | $1,445.44 | $1,778.28 |
Midlands Setting Facility Modifier None Typical Low $630.96 Median $1,071.52 Typical High $1,949.84 | Facility | None | $630.96 | $1,071.52 | $1,949.84 |
Midlands Setting Professional Modifier None Typical Low $1,318.26 Median $1,445.44 Typical High $1,778.28 | Professional | None | $1,318.26 | $1,445.44 | $1,778.28 |
Sanford Health Plan Setting Professional Modifier None Typical Low $912.01 Median $1,174.90 Typical High $1,548.82 | Professional | None | $912.01 | $1,174.90 | $1,548.82 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $691.83 Median $1,584.89 Typical High $2,187.76 | Professional | None | $691.83 | $1,584.89 | $2,187.76 |
Wellmark Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $2,041.74 | Professional | None | $1,230.27 | $1,445.44 | $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 $269.15 Median $346.74 Typical High $407.38 | Professional | 52 · Reduced service | $269.15 | $346.74 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $138.04 Typical High $162.18 | Professional | 53 · Discontinued | $109.65 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $407.38 Median $512.86 Typical High $616.60 | Professional | 54 · Surgery only | $407.38 | $512.86 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $81.28 Median $102.33 Typical High $123.03 | Professional | 55 · Aftercare only | $81.28 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $69.18 Typical High $81.28 | Professional | 56 · Pre-op care only | $54.95 | $69.18 | $81.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $380.19 Median $478.63 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $380.19 | $478.63 | $575.44 |
Where South Dakota sits
The same service costs 5.6 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
$1,445
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.