How much rates vary
Facilitymedian $3,890 · 10th to 90th $708 to $8,318Professionalmedian $7,762 · 10th to 90th $832 to $18,197
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 $512.86 Median $4,365.16 Typical High $6,760.83 | Facility | None | $512.86 | $4,365.16 | $6,760.83 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $1,412.54 Typical High $8,128.31 | Professional | None | $416.87 | $1,412.54 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $4,073.80 Median $5,888.44 Typical High $10,232.93 | Facility | None | $4,073.80 | $5,888.44 | $10,232.93 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,412.54 Typical High $15,488.17 | Professional | None | $1,000.00 | $1,412.54 | $15,488.17 |
Medica Setting Facility Modifier None Typical Low $707.95 Median $3,467.37 Typical High $8,317.64 | Facility | None | $707.95 | $3,467.37 | $8,317.64 |
Medica Setting Professional Modifier None Typical Low $5,754.40 Median $18,197.01 Typical High $52,480.75 | Professional | None | $5,754.40 | $18,197.01 | $52,480.75 |
Midlands Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $15,488.17 | Professional | None | $1,174.90 | $1,174.90 | $15,488.17 |
Midlands Setting Facility Modifier None Typical Low $4,073.80 Median $5,011.87 Typical High $5,888.44 | Facility | None | $4,073.80 | $5,011.87 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $1,071.52 Median $1,148.15 Typical High $16,218.10 | Professional | None | $1,071.52 | $1,148.15 | $16,218.10 |
Sanford Health Plan Setting Professional Modifier None Typical Low $812.83 Median $7,762.47 Typical High $11,748.98 | Professional | None | $812.83 | $7,762.47 | $11,748.98 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,890.45 | Facility | None | $3,235.94 | $3,235.94 | $3,890.45 |
United Setting Professional Modifier None Typical Low $616.60 Median $3,235.94 Typical High $19,054.61 | Professional | None | $616.60 | $3,235.94 | $19,054.61 |
Wellmark Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $14,791.08 | Professional | None | $977.24 | $1,148.15 | $14,791.08 |
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 $208.93 Median $524.81 Typical High $2,818.38 | Professional | 52 · Reduced service | $208.93 | $524.81 | $2,818.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $208.93 Typical High $1,122.02 | Professional | 53 · Discontinued | $83.18 | $208.93 | $1,122.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $776.25 Typical High $4,168.69 | Professional | 54 · Surgery only | $309.03 | $776.25 | $4,168.69 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $154.88 Typical High $851.14 | Professional | 55 · Aftercare only | $63.10 | $154.88 | $851.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $104.71 Typical High $562.34 | Professional | 56 · Pre-op care only | $41.69 | $104.71 | $562.34 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $724.44 Typical High $3,890.45 | Professional | 78 · Unplanned return to OR | $288.40 | $724.44 | $3,890.45 |
Where South Dakota sits
The same service costs 5.8 times more in Oklahoma than in Mississippi. 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.
Physician feeFacility fee
OK $20,151MS $3,493
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.