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 $588.84 Median $707.95 Typical High $4,365.16 | Facility | None | $588.84 | $707.95 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $616.60 Typical High $724.44 | Professional | None | $512.86 | $616.60 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $891.25 Typical High $1,348.96 | Facility | None | $457.09 | $891.25 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $1,122.02 Median $1,412.54 Typical High $2,137.96 | Professional | None | $1,122.02 | $1,412.54 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $741.31 Median $870.96 Typical High $1,584.89 | Facility | None | $741.31 | $870.96 | $1,584.89 |
Medica Setting Professional Modifier None Typical Low $630.96 Median $1,862.09 Typical High $5,248.07 | Professional | None | $630.96 | $1,862.09 | $5,248.07 |
Midlands Setting Professional Modifier None Typical Low $1,318.26 Median $1,318.26 Typical High $1,548.82 | Professional | None | $1,318.26 | $1,318.26 | $1,548.82 |
Midlands Setting Facility Modifier None Typical Low $457.09 Median $891.25 Typical High $954.99 | Facility | None | $457.09 | $891.25 | $954.99 |
Midlands Setting Professional Modifier None Typical Low $1,174.90 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,174.90 | $1,380.38 | $1,698.24 |
Sanford Health Plan Setting Professional Modifier None Typical Low $691.83 Median $1,096.48 Typical High $1,380.38 | Professional | None | $691.83 | $1,096.48 | $1,380.38 |
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 $602.56 Median $1,479.11 Typical High $1,949.84 | Professional | None | $602.56 | $1,479.11 | $1,949.84 |
Wellmark Setting Professional Modifier None Typical Low $1,230.27 Median $1,445.44 Typical High $1,819.70 | Professional | None | $1,230.27 | $1,445.44 | $1,819.70 |
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 $309.03 Typical High $363.08 | Professional | 52 · Reduced service | $257.04 | $309.03 | $363.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $123.03 Typical High $147.91 | Professional | 53 · Discontinued | $102.33 | $123.03 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $457.09 Typical High $549.54 | Professional | 54 · Surgery only | $380.19 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $75.86 Median $91.20 Typical High $109.65 | Professional | 55 · Aftercare only | $75.86 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $61.66 Typical High $72.44 | Professional | 56 · Pre-op care only | $51.29 | $61.66 | $72.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $426.58 Typical High $512.86 | Professional | 78 · Unplanned return to OR | $354.81 | $426.58 | $512.86 |
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
$1,318
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.