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 $165.96 Median $263.03 Typical High $4,365.16 | Facility | None | $165.96 | $263.03 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $263.03 | Professional | None | $138.04 | $218.78 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $269.15 Typical High $478.63 | Facility | None | $218.78 | $269.15 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $478.63 Typical High $676.08 | Professional | None | $323.59 | $478.63 | $676.08 |
Medica Setting Facility Modifier None Typical Low $213.80 Median $380.19 Typical High $1,202.26 | Facility | None | $213.80 | $380.19 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $229.09 Median $630.96 Typical High $1,905.46 | Professional | None | $229.09 | $630.96 | $1,905.46 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $588.84 | Professional | None | $380.19 | $380.19 | $588.84 |
Midlands Setting Facility Modifier None Typical Low $218.78 Median $263.03 Typical High $295.12 | Facility | None | $218.78 | $263.03 | $295.12 |
Midlands Setting Professional Modifier None Typical Low $338.84 Median $371.54 Typical High $575.44 | Professional | None | $338.84 | $371.54 | $575.44 |
Sanford Health Plan Setting Professional Modifier None Typical Low $208.93 Median $323.59 Typical High $478.63 | Professional | None | $208.93 | $323.59 | $478.63 |
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 $199.53 Median $436.52 Typical High $724.44 | Professional | None | $199.53 | $436.52 | $724.44 |
Wellmark Setting Professional Modifier None Typical Low $323.59 Median $380.19 Typical High $676.08 | Professional | None | $323.59 | $380.19 | $676.08 |
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 $69.18 Median $112.20 Typical High $131.83 | Professional | 52 · Reduced service | $69.18 | $112.20 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $44.67 Typical High $52.48 | Professional | 53 · Discontinued | $27.54 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $165.96 Typical High $199.53 | Professional | 54 · Surgery only | $104.71 | $165.96 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $33.11 Typical High $39.81 | Professional | 55 · Aftercare only | $20.89 | $33.11 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $22.39 Typical High $26.30 | Professional | 56 · Pre-op care only | $13.80 | $22.39 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $154.88 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $97.72 | $154.88 | $186.21 |
Where South Dakota sits
The same service costs 3.7 times more in Alaska than in Utah. 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· 7th of 51
$380
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.