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 $309.03 Median $331.13 Typical High $4,365.16 | Facility | None | $309.03 | $331.13 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $302.00 Typical High $446.68 | Professional | None | $269.15 | $302.00 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $645.65 | Facility | None | $123.03 | $173.78 | $645.65 |
Cigna Setting Professional Modifier None Typical Low $588.84 Median $758.58 Typical High $1,023.29 | Professional | None | $588.84 | $758.58 | $1,023.29 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $457.09 Typical High $741.31 | Facility | None | $125.89 | $457.09 | $741.31 |
Medica Setting Professional Modifier None Typical Low $309.03 Median $812.83 Typical High $2,570.40 | Professional | None | $309.03 | $812.83 | $2,570.40 |
Midlands Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $758.58 | Professional | None | $691.83 | $691.83 | $758.58 |
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 $630.96 Median $676.08 Typical High $741.31 | Professional | None | $630.96 | $676.08 | $741.31 |
Sanford Health Plan Setting Professional Modifier None Typical Low $354.81 Median $549.54 Typical High $691.83 | Professional | None | $354.81 | $549.54 | $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 $295.12 Median $660.69 Typical High $933.25 | Professional | None | $295.12 | $660.69 | $933.25 |
Wellmark Setting Professional Modifier None Typical Low $691.83 Median $812.83 Typical High $954.99 | Professional | None | $691.83 | $812.83 | $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 $134.90 Median $147.91 Typical High $177.83 | Professional | 52 · Reduced service | $134.90 | $147.91 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $58.88 Typical High $70.79 | Professional | 53 · Discontinued | $53.70 | $58.88 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $223.87 Typical High $263.03 | Professional | 54 · Surgery only | $204.17 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $44.67 Typical High $53.70 | Professional | 55 · Aftercare only | $40.74 | $44.67 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $29.51 Typical High $35.48 | Professional | 56 · Pre-op care only | $26.92 | $29.51 | $35.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $190.55 Median $208.93 Typical High $245.47 | Professional | 78 · Unplanned return to OR | $190.55 | $208.93 | $245.47 |
Where South Dakota sits
The same service costs 5.9 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
$676
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.