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 $501.19 Median $676.08 Typical High $4,365.16 | Facility | None | $501.19 | $676.08 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $416.87 Median $562.34 Typical High $676.08 | Professional | None | $416.87 | $562.34 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $977.24 Median $1,348.96 Typical High $2,137.96 | Facility | None | $977.24 | $1,348.96 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,348.96 Typical High $1,698.24 | Professional | None | $1,000.00 | $1,348.96 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $660.69 Median $954.99 Typical High $1,698.24 | Facility | None | $660.69 | $954.99 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $645.65 Median $1,698.24 Typical High $4,897.79 | Professional | None | $645.65 | $1,698.24 | $4,897.79 |
Midlands Setting Professional Modifier None Typical Low $1,174.90 Median $1,174.90 Typical High $1,584.89 | Professional | None | $1,174.90 | $1,174.90 | $1,584.89 |
Midlands Setting Facility Modifier None Typical Low $1,288.25 Median $1,479.11 Typical High $2,238.72 | Facility | None | $1,288.25 | $1,479.11 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,122.02 Typical High $1,548.82 | Professional | None | $1,023.29 | $1,122.02 | $1,548.82 |
Sanford Health Plan Setting Professional Modifier None Typical Low $707.95 Median $912.01 Typical High $1,202.26 | Professional | None | $707.95 | $912.01 | $1,202.26 |
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 $575.44 Median $1,318.26 Typical High $1,905.46 | Professional | None | $575.44 | $1,318.26 | $1,905.46 |
Wellmark Setting Professional Modifier None Typical Low $977.24 Median $1,148.15 Typical High $1,659.59 | Professional | None | $977.24 | $1,148.15 | $1,659.59 |
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 $208.93 Median $281.84 Typical High $331.13 | Professional | 52 · Reduced service | $208.93 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $112.20 Typical High $134.90 | Professional | 53 · Discontinued | $83.18 | $112.20 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $309.03 Median $426.58 Typical High $501.19 | Professional | 54 · Surgery only | $309.03 | $426.58 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $85.11 Typical High $100.00 | Professional | 55 · Aftercare only | $63.10 | $85.11 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $56.23 Typical High $67.61 | Professional | 56 · Pre-op care only | $41.69 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $288.40 Median $398.11 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $288.40 | $398.11 | $467.74 |
Where South Dakota sits
The same service costs 5.8 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
$1,175
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.