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 $316.23 Median $478.63 Typical High $4,365.16 | Facility | None | $316.23 | $478.63 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $269.15 Median $398.11 Typical High $512.86 | Professional | None | $269.15 | $398.11 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $676.08 Median $954.99 Typical High $1,047.13 | Facility | None | $676.08 | $954.99 | $1,047.13 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $1,202.26 | Professional | None | $616.60 | $933.25 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $660.69 Typical High $1,202.26 | Facility | None | $446.68 | $660.69 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $426.58 Median $1,202.26 Typical High $3,388.44 | Professional | None | $426.58 | $1,202.26 | $3,388.44 |
Midlands Setting Professional Modifier None Typical Low $724.44 Median $724.44 Typical High $1,096.48 | Professional | None | $724.44 | $724.44 | $1,096.48 |
Midlands Setting Facility Modifier None Typical Low $812.83 Median $954.99 Typical High $1,202.26 | Facility | None | $812.83 | $954.99 | $1,202.26 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $707.95 Typical High $1,071.52 | Professional | None | $645.65 | $707.95 | $1,071.52 |
Sanford Health Plan Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $851.14 | Professional | None | $398.11 | $616.60 | $851.14 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $363.08 Median $851.14 Typical High $1,348.96 | Professional | None | $363.08 | $851.14 | $1,348.96 |
Wellmark Setting Professional Modifier None Typical Low $630.96 Median $741.31 Typical High $1,174.90 | Professional | None | $630.96 | $741.31 | $1,174.90 |
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 $199.53 Typical High $234.42 | Professional | 52 · Reduced service | $131.83 | $199.53 | $234.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $53.70 Median $79.43 Typical High $93.33 | Professional | 53 · Discontinued | $53.70 | $79.43 | $93.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $295.12 Typical High $346.74 | Professional | 54 · Surgery only | $199.53 | $295.12 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $58.88 Typical High $69.18 | Professional | 55 · Aftercare only | $39.81 | $58.88 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.92 Median $39.81 Typical High $46.77 | Professional | 56 · Pre-op care only | $26.92 | $39.81 | $46.77 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $275.42 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $186.21 | $275.42 | $323.59 |
Where South Dakota sits
The same service costs 4.9 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· 6th of 51
$741
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.