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 $478.63 Median $512.86 Typical High $4,365.16 | Facility | None | $478.63 | $512.86 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $446.68 Typical High $645.65 | Professional | None | $416.87 | $446.68 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $977.24 | Facility | None | $123.03 | $173.78 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $891.25 Median $1,148.15 Typical High $1,479.11 | Professional | None | $891.25 | $1,148.15 | $1,479.11 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $707.95 Typical High $812.83 | Facility | None | $125.89 | $707.95 | $812.83 |
Medica Setting Professional Modifier None Typical Low $467.74 Median $1,230.27 Typical High $3,890.45 | Professional | None | $467.74 | $1,230.27 | $3,890.45 |
Midlands Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,148.15 | Professional | None | $1,071.52 | $1,071.52 | $1,148.15 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $645.65 | Facility | None | $123.03 | $173.78 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $977.24 Median $1,047.13 Typical High $1,122.02 | Professional | None | $977.24 | $1,047.13 | $1,122.02 |
Sanford Health Plan Setting Professional Modifier None Typical Low $575.44 Median $851.14 Typical High $1,096.48 | Professional | None | $575.44 | $851.14 | $1,096.48 |
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 $457.09 Median $1,000.00 Typical High $1,412.54 | Professional | None | $457.09 | $1,000.00 | $1,412.54 |
Wellmark Setting Professional Modifier None Typical Low $1,047.13 Median $1,230.27 Typical High $1,479.11 | Professional | None | $1,047.13 | $1,230.27 | $1,479.11 |
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 $208.93 Median $223.87 Typical High $269.15 | Professional | 52 · Reduced service | $208.93 | $223.87 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $89.13 Typical High $107.15 | Professional | 53 · Discontinued | $83.18 | $89.13 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $316.23 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $67.61 Typical High $81.28 | Professional | 55 · Aftercare only | $63.10 | $67.61 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $44.67 Typical High $53.70 | Professional | 56 · Pre-op care only | $41.69 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $295.12 | $316.23 | $371.54 |
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
$1,047
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.