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 $346.74 Median $380.19 Typical High $4,365.16 | Facility | None | $346.74 | $380.19 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $338.84 Typical High $512.86 | Professional | None | $309.03 | $338.84 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $181.97 Typical High $741.31 | Facility | None | $123.03 | $181.97 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $1,174.90 | Professional | None | $660.69 | $851.14 | $1,174.90 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $512.86 Typical High $812.83 | Facility | None | $125.89 | $512.86 | $812.83 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $933.25 Typical High $2,951.21 | Professional | None | $346.74 | $933.25 | $2,951.21 |
Midlands Setting Professional Modifier None Typical Low $776.25 Median $776.25 Typical High $851.14 | Professional | None | $776.25 | $776.25 | $851.14 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $181.97 Typical High $645.65 | Facility | None | $123.03 | $181.97 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $707.95 Median $758.58 Typical High $831.76 | Professional | None | $707.95 | $758.58 | $831.76 |
Sanford Health Plan Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $794.33 | Professional | None | $407.38 | $630.96 | $794.33 |
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 $331.13 Median $741.31 Typical High $1,047.13 | Professional | None | $331.13 | $741.31 | $1,047.13 |
Wellmark Setting Professional Modifier None Typical Low $776.25 Median $912.01 Typical High $1,096.48 | Professional | None | $776.25 | $912.01 | $1,096.48 |
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 $154.88 Median $169.82 Typical High $204.17 | Professional | 52 · Reduced service | $154.88 | $169.82 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $67.61 Typical High $81.28 | Professional | 53 · Discontinued | $61.66 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $251.19 Typical High $302.00 | Professional | 54 · Surgery only | $229.09 | $251.19 | $302.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $51.29 Typical High $60.26 | Professional | 55 · Aftercare only | $46.77 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $33.88 Typical High $40.74 | Professional | 56 · Pre-op care only | $30.90 | $33.88 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $234.42 Typical High $281.84 | Professional | 78 · Unplanned return to OR | $213.80 | $234.42 | $281.84 |
Where South Dakota sits
The same service costs 5.1 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· 5th of 51
$776
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.