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 $288.40 Typical High $4,365.16 | Facility | None | $257.04 | $288.40 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $257.04 Typical High $398.11 | Professional | None | $229.09 | $257.04 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $562.34 | Facility | None | $123.03 | $173.78 | $562.34 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $645.65 Typical High $812.83 | Professional | None | $489.78 | $645.65 | $812.83 |
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 $691.83 Typical High $2,238.72 | Professional | None | $257.04 | $691.83 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $645.65 | Professional | None | $575.44 | $575.44 | $645.65 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $162.18 Typical High $218.78 | Facility | None | $123.03 | $162.18 | $218.78 |
Midlands Setting Professional Modifier None Typical Low $512.86 Median $549.54 Typical High $616.60 | Professional | None | $512.86 | $549.54 | $616.60 |
Sanford Health Plan Setting Professional Modifier None Typical Low $281.84 Median $457.09 Typical High $602.56 | Professional | None | $281.84 | $457.09 | $602.56 |
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 $251.19 Median $549.54 Typical High $794.33 | Professional | None | $251.19 | $549.54 | $794.33 |
Wellmark Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $851.14 | Professional | None | $588.84 | $691.83 | $851.14 |
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 $128.82 Typical High $154.88 | Professional | 52 · Reduced service | $114.82 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $51.29 Typical High $61.66 | Professional | 53 · Discontinued | $45.71 | $51.29 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $194.98 Typical High $234.42 | Professional | 54 · Surgery only | $173.78 | $194.98 | $234.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $38.90 Typical High $46.77 | Professional | 55 · Aftercare only | $34.67 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $25.70 Typical High $30.90 | Professional | 56 · Pre-op care only | $22.91 | $25.70 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $181.97 Typical High $218.78 | Professional | 78 · Unplanned return to OR | $162.18 | $181.97 | $218.78 |
Where South Dakota sits
The same service costs 5.4 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
$575
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.