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 $75.86 Median $107.15 Typical High $4,365.16 | Facility | None | $75.86 | $107.15 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $91.20 Typical High $151.36 | Professional | None | $66.07 | $91.20 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $104.71 Median $173.78 Typical High $371.54 | Facility | None | $104.71 | $173.78 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $144.54 Median $194.98 Typical High $288.40 | Professional | None | $144.54 | $194.98 | $288.40 |
Medica Setting Facility Modifier None Typical Low $112.20 Median $144.54 Typical High $223.87 | Facility | None | $112.20 | $144.54 | $223.87 |
Medica Setting Professional Modifier None Typical Low $107.15 Median $245.47 Typical High $870.96 | Professional | None | $107.15 | $245.47 | $870.96 |
Midlands Setting Professional Modifier None Typical Low $169.82 Median $169.82 Typical High $229.09 | Professional | None | $169.82 | $169.82 | $229.09 |
Midlands Setting Facility Modifier None Typical Low $97.72 Median $123.03 Typical High $371.54 | Facility | None | $97.72 | $123.03 | $371.54 |
Midlands Setting Professional Modifier None Typical Low $151.36 Median $165.96 Typical High $218.78 | Professional | None | $151.36 | $165.96 | $218.78 |
Sanford Health Plan Setting Professional Modifier None Typical Low $114.82 Median $154.88 Typical High $223.87 | Professional | None | $114.82 | $154.88 | $223.87 |
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 $89.13 Median $194.98 Typical High $295.12 | Professional | None | $89.13 | $194.98 | $295.12 |
Wellmark Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $316.23 | Professional | None | $158.49 | $186.21 | $316.23 |
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 $33.11 Median $50.12 Typical High $60.26 | Professional | 52 · Reduced service | $33.11 | $50.12 | $60.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $20.42 Typical High $23.99 | Professional | 53 · Discontinued | $13.18 | $20.42 | $23.99 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $50.12 Median $75.86 Typical High $91.20 | Professional | 54 · Surgery only | $50.12 | $75.86 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.00 Median $15.14 Typical High $18.20 | Professional | 55 · Aftercare only | $10.00 | $15.14 | $18.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $10.00 Typical High $12.02 | Professional | 56 · Pre-op care only | $6.61 | $10.00 | $12.02 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $46.77 Median $70.79 Typical High $85.11 | Professional | 78 · Unplanned return to OR | $46.77 | $70.79 | $85.11 |
Where South Dakota sits
The same service costs 3.7 times more in Alaska 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· 5th of 51
$186
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.