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 $257.04 Median $269.15 Typical High $4,365.16 | Facility | None | $257.04 | $269.15 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $323.59 | Professional | None | $229.09 | $257.04 | $323.59 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $181.97 Typical High $524.81 | Facility | None | $123.03 | $181.97 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $478.63 Median $602.56 Typical High $831.76 | Professional | None | $478.63 | $602.56 | $831.76 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $389.05 Typical High $630.96 | Facility | None | $125.89 | $389.05 | $630.96 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $660.69 Typical High $2,089.30 | Professional | None | $257.04 | $660.69 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $602.56 | Professional | None | $575.44 | $575.44 | $602.56 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $218.78 | Facility | None | $123.03 | $173.78 | $218.78 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $562.34 Typical High $588.84 | Professional | None | $524.81 | $562.34 | $588.84 |
Sanford Health Plan Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $588.84 | Professional | None | $309.03 | $457.09 | $588.84 |
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 $234.42 Median $524.81 Typical High $741.31 | Professional | None | $234.42 | $524.81 | $741.31 |
Wellmark Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $794.33 | Professional | None | $588.84 | $676.08 | $794.33 |
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 $114.82 Median $120.23 Typical High $144.54 | Professional | 52 · Reduced service | $114.82 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $47.86 Typical High $57.54 | Professional | 53 · Discontinued | $45.71 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $181.97 Typical High $213.80 | Professional | 54 · Surgery only | $173.78 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $36.31 Typical High $43.65 | Professional | 55 · Aftercare only | $34.67 | $36.31 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $23.99 Typical High $28.84 | Professional | 56 · Pre-op care only | $22.91 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $169.82 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $162.18 | $169.82 | $199.53 |
Where South Dakota sits
The same service costs 5.9 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
$562
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.