How much rates vary
Facilitymedian $1,479 · 10th to 90th $525 to $2,692Professionalmedian $891 · 10th to 90th $479 to $1,549
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 $363.08 Median $562.34 Typical High $4,365.16 | Facility | None | $363.08 | $562.34 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $457.09 Typical High $562.34 | Professional | None | $309.03 | $457.09 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,479.11 Typical High $5,011.87 | Facility | None | $812.83 | $1,479.11 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,071.52 Typical High $1,412.54 | Professional | None | $707.95 | $1,071.52 | $1,412.54 |
Medica Setting Facility Modifier None Typical Low $524.81 Median $794.33 Typical High $1,698.24 | Facility | None | $524.81 | $794.33 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,380.38 Typical High $4,073.80 | Professional | None | $489.78 | $1,380.38 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,258.93 | Professional | None | $831.76 | $831.76 | $1,258.93 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,479.11 Typical High $5,888.44 | Facility | None | $1,096.48 | $1,479.11 | $5,888.44 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $812.83 Typical High $1,258.93 | Professional | None | $758.58 | $812.83 | $1,258.93 |
Sanford Health Plan Setting Professional Modifier None Typical Low $537.03 Median $724.44 Typical High $1,023.29 | Professional | None | $537.03 | $724.44 | $1,023.29 |
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 $426.58 Median $954.99 Typical High $1,548.82 | Professional | None | $426.58 | $954.99 | $1,548.82 |
Wellmark Setting Professional Modifier None Typical Low $758.58 Median $891.25 Typical High $1,445.44 | Professional | None | $758.58 | $891.25 | $1,445.44 |
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 $154.88 Median $234.42 Typical High $281.84 | Professional | 52 · Reduced service | $154.88 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $93.33 Typical High $112.20 | Professional | 53 · Discontinued | $61.66 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $354.81 Typical High $416.87 | Professional | 54 · Surgery only | $234.42 | $354.81 | $416.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $70.79 Typical High $83.18 | Professional | 55 · Aftercare only | $46.77 | $70.79 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $46.77 Typical High $56.23 | Professional | 56 · Pre-op care only | $30.90 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $331.13 Typical High $389.05 | Professional | 78 · Unplanned return to OR | $218.78 | $331.13 | $389.05 |
Where South Dakota sits
The same service costs 6.4 times more in Alaska than in Montana. 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.
Physician feeFacility fee
AK $8,723MT $1,361
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.