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 $239.88 Median $380.19 Typical High $4,365.16 | Facility | None | $239.88 | $380.19 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $204.17 Median $316.23 Typical High $371.54 | Professional | None | $204.17 | $316.23 | $371.54 |
Cigna Setting Facility Modifier None Typical Low $549.54 Median $1,348.96 Typical High $2,137.96 | Facility | None | $549.54 | $1,348.96 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $954.99 | Professional | None | $467.74 | $707.95 | $954.99 |
Medica Setting Facility Modifier None Typical Low $338.84 Median $537.03 Typical High $1,698.24 | Facility | None | $338.84 | $537.03 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $354.81 Median $977.24 Typical High $2,754.23 | Professional | None | $354.81 | $977.24 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $549.54 Typical High $870.96 | Professional | None | $549.54 | $549.54 | $870.96 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,479.11 Typical High $2,238.72 | Facility | None | $954.99 | $1,479.11 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $489.78 Median $549.54 Typical High $891.25 | Professional | None | $489.78 | $549.54 | $891.25 |
Sanford Health Plan Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $676.08 | Professional | None | $323.59 | $467.74 | $676.08 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,513.56 | $1,513.56 | $1,819.70 |
United Setting Professional Modifier None Typical Low $288.40 Median $630.96 Typical High $1,071.52 | Professional | None | $288.40 | $630.96 | $1,071.52 |
Wellmark Setting Professional Modifier None Typical Low $478.63 Median $562.34 Typical High $912.01 | Professional | None | $478.63 | $562.34 | $912.01 |
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 $102.33 Median $158.49 Typical High $186.21 | Professional | 52 · Reduced service | $102.33 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $40.74 Median $63.10 Typical High $74.13 | Professional | 53 · Discontinued | $40.74 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $151.36 Median $239.88 Typical High $281.84 | Professional | 54 · Surgery only | $151.36 | $239.88 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $30.20 Median $47.86 Typical High $56.23 | Professional | 55 · Aftercare only | $30.20 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $20.42 Median $31.62 Typical High $37.15 | Professional | 56 · Pre-op care only | $20.42 | $31.62 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $141.25 Median $223.87 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $141.25 | $223.87 | $263.03 |
Where South Dakota sits
The same service costs 5.5 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· 6th of 51
$603
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.