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 $371.54 Median $537.03 Typical High $4,365.16 | Facility | None | $371.54 | $537.03 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $446.68 Typical High $549.54 | Professional | None | $316.23 | $446.68 | $549.54 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $812.83 Typical High $1,288.25 | Facility | None | $537.03 | $812.83 | $1,288.25 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $1,047.13 Typical High $1,548.82 | Professional | None | $741.31 | $1,047.13 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $645.65 Typical High $851.14 | Facility | None | $446.68 | $645.65 | $851.14 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,348.96 Typical High $3,890.45 | Professional | None | $489.78 | $1,348.96 | $3,890.45 |
Midlands Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,258.93 | Professional | None | $870.96 | $870.96 | $1,258.93 |
Midlands Setting Facility Modifier None Typical Low $537.03 Median $1,000.00 Typical High $1,288.25 | Facility | None | $537.03 | $1,000.00 | $1,288.25 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $831.76 Typical High $1,202.26 | Professional | None | $758.58 | $831.76 | $1,202.26 |
Sanford Health Plan Setting Professional Modifier None Typical Low $467.74 Median $707.95 Typical High $954.99 | Professional | None | $467.74 | $707.95 | $954.99 |
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 $436.52 Median $1,000.00 Typical High $1,513.56 | Professional | None | $436.52 | $1,000.00 | $1,513.56 |
Wellmark Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,318.26 | Professional | None | $741.31 | $870.96 | $1,318.26 |
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 $158.49 Median $223.87 Typical High $263.03 | Professional | 52 · Reduced service | $158.49 | $223.87 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $89.13 Typical High $104.71 | Professional | 53 · Discontinued | $63.10 | $89.13 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $338.84 Typical High $398.11 | Professional | 54 · Surgery only | $234.42 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $67.61 Typical High $79.43 | Professional | 55 · Aftercare only | $46.77 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $44.67 Typical High $52.48 | Professional | 56 · Pre-op care only | $31.62 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $316.23 Typical High $371.54 | Professional | 78 · Unplanned return to OR | $218.78 | $316.23 | $371.54 |
Where South Dakota sits
The same service costs 4.8 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
$871
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.