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 $295.12 Median $323.59 Typical High $4,365.16 | Facility | None | $295.12 | $323.59 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $371.54 | Professional | None | $263.03 | $295.12 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $630.96 | Facility | None | $123.03 | $173.78 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $575.44 Median $724.44 Typical High $933.25 | Professional | None | $575.44 | $724.44 | $933.25 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $446.68 Typical High $724.44 | Facility | None | $125.89 | $446.68 | $724.44 |
Medica Setting Professional Modifier None Typical Low $295.12 Median $794.33 Typical High $2,511.89 | Professional | None | $295.12 | $794.33 | $2,511.89 |
Midlands Setting Professional Modifier None Typical Low $676.08 Median $676.08 Typical High $724.44 | Professional | None | $676.08 | $676.08 | $724.44 |
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 $616.60 Median $645.65 Typical High $707.95 | Professional | None | $616.60 | $645.65 | $707.95 |
Sanford Health Plan Setting Professional Modifier None Typical Low $338.84 Median $537.03 Typical High $691.83 | Professional | None | $338.84 | $537.03 | $691.83 |
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 $281.84 Median $630.96 Typical High $891.25 | Professional | None | $281.84 | $630.96 | $891.25 |
Wellmark Setting Professional Modifier None Typical Low $676.08 Median $794.33 Typical High $933.25 | Professional | None | $676.08 | $794.33 | $933.25 |
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 $131.83 Median $144.54 Typical High $173.78 | Professional | 52 · Reduced service | $131.83 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $57.54 Typical High $69.18 | Professional | 53 · Discontinued | $52.48 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $213.80 Typical High $257.04 | Professional | 54 · Surgery only | $199.53 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $43.65 Typical High $51.29 | Professional | 55 · Aftercare only | $39.81 | $43.65 | $51.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $28.84 Typical High $34.67 | Professional | 56 · Pre-op care only | $26.30 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $199.53 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $186.21 | $199.53 | $239.88 |
Where South Dakota sits
The same service costs 5.8 times more in Alaska than in Utah. 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
$661
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.