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 $134.90 Median $257.04 Typical High $4,365.16 | Facility | None | $134.90 | $257.04 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $208.93 Typical High $263.03 | Professional | None | $114.82 | $208.93 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $234.42 Median $281.84 Typical High $446.68 | Facility | None | $234.42 | $281.84 | $446.68 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $707.95 | Professional | None | $269.15 | $389.05 | $707.95 |
Medica Setting Facility Modifier None Typical Low $190.55 Median $354.81 Typical High $676.08 | Facility | None | $190.55 | $354.81 | $676.08 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $660.69 Typical High $1,862.09 | Professional | None | $223.87 | $660.69 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $316.23 Typical High $588.84 | Professional | None | $316.23 | $316.23 | $588.84 |
Midlands Setting Facility Modifier None Typical Low $229.09 Median $245.47 Typical High $309.03 | Facility | None | $229.09 | $245.47 | $309.03 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $302.00 Typical High $588.84 | Professional | None | $275.42 | $302.00 | $588.84 |
Sanford Health Plan Setting Professional Modifier None Typical Low $169.82 Median $302.00 Typical High $446.68 | Professional | None | $169.82 | $302.00 | $446.68 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $162.18 Median $363.08 Typical High $724.44 | Professional | None | $162.18 | $363.08 | $724.44 |
Wellmark Setting Professional Modifier None Typical Low $275.42 Median $323.59 Typical High $616.60 | Professional | None | $275.42 | $323.59 | $616.60 |
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 $56.23 Median $104.71 Typical High $120.23 | Professional | 52 · Reduced service | $56.23 | $104.71 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $41.69 Typical High $48.98 | Professional | 53 · Discontinued | $22.91 | $41.69 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $154.88 Typical High $181.97 | Professional | 54 · Surgery only | $85.11 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $30.90 Typical High $36.31 | Professional | 55 · Aftercare only | $16.98 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $20.89 Typical High $24.55 | Professional | 56 · Pre-op care only | $11.48 | $20.89 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $144.54 Typical High $169.82 | Professional | 78 · Unplanned return to OR | $79.43 | $144.54 | $169.82 |
Where South Dakota sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 7th of 51
$347
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.