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 $281.84 Median $309.03 Typical High $4,365.16 | Facility | None | $281.84 | $309.03 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $275.42 Typical High $354.81 | Professional | None | $251.19 | $275.42 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $588.84 | Facility | None | $123.03 | $173.78 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $691.83 Typical High $933.25 | Professional | None | $537.03 | $691.83 | $933.25 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $416.87 Typical High $691.83 | Facility | None | $125.89 | $416.87 | $691.83 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $758.58 Typical High $2,344.23 | Professional | None | $281.84 | $758.58 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $691.83 | Professional | None | $645.65 | $645.65 | $691.83 |
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 $575.44 Median $616.60 Typical High $676.08 | Professional | None | $575.44 | $616.60 | $676.08 |
Sanford Health Plan Setting Professional Modifier None Typical Low $316.23 Median $501.19 Typical High $645.65 | Professional | None | $316.23 | $501.19 | $645.65 |
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 $269.15 Median $602.56 Typical High $851.14 | Professional | None | $269.15 | $602.56 | $851.14 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $870.96 | Professional | None | $630.96 | $741.31 | $870.96 |
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 $125.89 Median $134.90 Typical High $162.18 | Professional | 52 · Reduced service | $125.89 | $134.90 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $53.70 Typical High $64.57 | Professional | 53 · Discontinued | $50.12 | $53.70 | $64.57 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $204.17 Typical High $245.47 | Professional | 54 · Surgery only | $186.21 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $40.74 Typical High $48.98 | Professional | 55 · Aftercare only | $37.15 | $40.74 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $26.92 Typical High $32.36 | Professional | 56 · Pre-op care only | $25.12 | $26.92 | $32.36 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $190.55 Typical High $229.09 | Professional | 78 · Unplanned return to OR | $173.78 | $190.55 | $229.09 |
Where South Dakota sits
The same service costs 5.8 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
$631
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.