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 $288.40 Median $316.23 Typical High $4,365.16 | Facility | None | $288.40 | $316.23 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $288.40 Typical High $389.05 | Professional | None | $251.19 | $288.40 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $181.97 Typical High $602.56 | Facility | None | $123.03 | $181.97 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $549.54 Median $707.95 Typical High $954.99 | Professional | None | $549.54 | $707.95 | $954.99 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $426.58 Typical High $741.31 | Facility | None | $125.89 | $426.58 | $741.31 |
Medica Setting Professional Modifier None Typical Low $288.40 Median $776.25 Typical High $2,398.83 | Professional | None | $288.40 | $776.25 | $2,398.83 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $707.95 | Professional | None | $645.65 | $645.65 | $707.95 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $181.97 Typical High $645.65 | Facility | None | $123.03 | $181.97 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $588.84 Median $630.96 Typical High $707.95 | Professional | None | $588.84 | $630.96 | $707.95 |
Sanford Health Plan Setting Professional Modifier None Typical Low $338.84 Median $512.86 Typical High $645.65 | Professional | None | $338.84 | $512.86 | $645.65 |
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 $275.42 Median $616.60 Typical High $870.96 | Professional | None | $275.42 | $616.60 | $870.96 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $891.25 | Professional | None | $630.96 | $741.31 | $891.25 |
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 $125.89 Median $138.04 Typical High $165.96 | Professional | 52 · Reduced service | $125.89 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $54.95 Typical High $66.07 | Professional | 53 · Discontinued | $50.12 | $54.95 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $190.55 Median $208.93 Typical High $251.19 | Professional | 54 · Surgery only | $190.55 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $41.69 Typical High $50.12 | Professional | 55 · Aftercare only | $38.02 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $27.54 Typical High $33.11 | Professional | 56 · Pre-op care only | $25.12 | $27.54 | $33.11 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $177.83 Median $194.98 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $177.83 | $194.98 | $234.42 |
Where South Dakota sits
The same service costs 5.5 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
$631
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.