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 $288.40 Median $302.00 Typical High $4,365.16 | Facility | None | $288.40 | $302.00 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $263.03 Typical High $398.11 | Professional | None | $251.19 | $263.03 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $371.54 Typical High $575.44 | Facility | None | $173.78 | $371.54 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $691.83 Typical High $870.96 | Professional | None | $524.81 | $691.83 | $870.96 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $407.38 Typical High $691.83 | Facility | None | $125.89 | $407.38 | $691.83 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $741.31 Typical High $2,344.23 | Professional | None | $281.84 | $741.31 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $691.83 | Professional | None | $645.65 | $645.65 | $691.83 |
Midlands Setting Facility Modifier None Typical Low $162.18 Median $218.78 Typical High $645.65 | Facility | None | $162.18 | $218.78 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $602.56 Median $616.60 Typical High $676.08 | Professional | None | $602.56 | $616.60 | $676.08 |
Sanford Health Plan Setting Professional Modifier None Typical Low $331.13 Median $512.86 Typical High $645.65 | Professional | None | $331.13 | $512.86 | $645.65 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $269.15 Median $602.56 Typical High $831.76 | Professional | None | $269.15 | $602.56 | $831.76 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $870.96 | Professional | None | $630.96 | $741.31 | $870.96 |
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 $125.89 Median $131.83 Typical High $158.49 | Professional | 52 · Reduced service | $125.89 | $131.83 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $52.48 Typical High $63.10 | Professional | 53 · Discontinued | $50.12 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $199.53 Typical High $234.42 | Professional | 54 · Surgery only | $190.55 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $39.81 Typical High $46.77 | Professional | 55 · Aftercare only | $38.02 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.30 Typical High $31.62 | Professional | 56 · Pre-op care only | $25.12 | $26.30 | $31.62 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $186.21 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $177.83 | $186.21 | $218.78 |
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· 5th of 51
$631
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.