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 $416.87 Median $457.09 Typical High $4,365.16 | Facility | None | $416.87 | $457.09 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $363.08 Median $407.38 Typical High $478.63 | Professional | None | $363.08 | $407.38 | $478.63 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $870.96 Typical High $1,122.02 | Facility | None | $123.03 | $870.96 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $794.33 Median $1,023.29 Typical High $1,258.93 | Professional | None | $794.33 | $1,023.29 | $1,258.93 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $616.60 Typical High $812.83 | Facility | None | $125.89 | $616.60 | $812.83 |
Medica Setting Professional Modifier None Typical Low $407.38 Median $1,096.48 Typical High $3,548.13 | Professional | None | $407.38 | $1,096.48 | $3,548.13 |
Midlands Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,023.29 | Professional | None | $954.99 | $954.99 | $1,023.29 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $954.99 Typical High $1,174.90 | Facility | None | $123.03 | $954.99 | $1,174.90 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $912.01 Typical High $1,000.00 | Professional | None | $870.96 | $912.01 | $1,000.00 |
Sanford Health Plan Setting Professional Modifier None Typical Low $524.81 Median $758.58 Typical High $954.99 | Professional | None | $524.81 | $758.58 | $954.99 |
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 $407.38 Median $891.25 Typical High $1,258.93 | Professional | None | $407.38 | $891.25 | $1,258.93 |
Wellmark Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,318.26 | Professional | None | $912.01 | $1,071.52 | $1,318.26 |
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 $181.97 Median $199.53 Typical High $239.88 | Professional | 52 · Reduced service | $181.97 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $81.28 Typical High $95.50 | Professional | 53 · Discontinued | $72.44 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $302.00 Typical High $363.08 | Professional | 54 · Surgery only | $275.42 | $302.00 | $363.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $60.26 Typical High $72.44 | Professional | 55 · Aftercare only | $54.95 | $60.26 | $72.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $40.74 Typical High $47.86 | Professional | 56 · Pre-op care only | $36.31 | $40.74 | $47.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $281.84 Typical High $338.84 | Professional | 78 · Unplanned return to OR | $257.04 | $281.84 | $338.84 |
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
$933
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.