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 $138.04 Median $309.03 Typical High $4,365.16 | Facility | None | $138.04 | $309.03 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $223.87 Typical High $346.74 | Professional | None | $120.23 | $223.87 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $147.91 Typical High $630.96 | Facility | None | $117.49 | $147.91 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $467.74 Typical High $870.96 | Professional | None | $263.03 | $467.74 | $870.96 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $223.87 Typical High $501.19 | Facility | None | $125.89 | $223.87 | $501.19 |
Medica Setting Professional Modifier None Typical Low $263.03 Median $660.69 Typical High $2,570.40 | Professional | None | $263.03 | $660.69 | $2,570.40 |
Midlands Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $616.60 | Professional | None | $309.03 | $309.03 | $616.60 |
Midlands Setting Facility Modifier None Typical Low $117.49 Median $141.25 Typical High $208.93 | Facility | None | $117.49 | $141.25 | $208.93 |
Midlands Setting Professional Modifier None Typical Low $288.40 Median $302.00 Typical High $588.84 | Professional | None | $288.40 | $302.00 | $588.84 |
Sanford Health Plan Setting Professional Modifier None Typical Low $199.53 Median $331.13 Typical High $616.60 | Professional | None | $199.53 | $331.13 | $616.60 |
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 $162.18 Median $380.19 Typical High $851.14 | Professional | None | $162.18 | $380.19 | $851.14 |
Wellmark Setting Professional Modifier None Typical Low $316.23 Median $371.54 Typical High $954.99 | Professional | None | $316.23 | $371.54 | $954.99 |
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 $60.26 Median $144.54 Typical High $173.78 | Professional | 52 · Reduced service | $60.26 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $57.54 Typical High $69.18 | Professional | 53 · Discontinued | $23.99 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $91.20 Median $213.80 Typical High $257.04 | Professional | 54 · Surgery only | $91.20 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.20 Median $42.66 Typical High $51.29 | Professional | 55 · Aftercare only | $18.20 | $42.66 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $28.84 Typical High $34.67 | Professional | 56 · Pre-op care only | $12.02 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $85.11 Median $199.53 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $85.11 | $199.53 | $239.88 |
Where South Dakota sits
The same service costs 3.6 times more in Wisconsin than in Kentucky. 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· 8th of 51
$372
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.