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 $281.84 Median $436.52 Typical High $4,365.16 | Facility | None | $281.84 | $436.52 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $239.88 Median $363.08 Typical High $457.09 | Professional | None | $239.88 | $363.08 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $616.60 Median $1,479.11 Typical High $2,187.76 | Facility | None | $616.60 | $1,479.11 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $562.34 Median $831.76 Typical High $1,096.48 | Professional | None | $562.34 | $831.76 | $1,096.48 |
Medica Setting Facility Modifier None Typical Low $371.54 Median $616.60 Typical High $1,698.24 | Facility | None | $371.54 | $616.60 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $1,174.90 Typical High $3,162.28 | Professional | None | $478.63 | $1,174.90 | $3,162.28 |
Midlands Setting Professional Modifier None Typical Low $660.69 Median $660.69 Typical High $1,000.00 | Professional | None | $660.69 | $660.69 | $1,000.00 |
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 $575.44 Median $794.33 Typical High $1,258.93 | Professional | None | $575.44 | $794.33 | $1,258.93 |
Sanford Health Plan Setting Professional Modifier None Typical Low $407.38 Median $549.54 Typical High $851.14 | Professional | None | $407.38 | $549.54 | $851.14 |
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 $363.08 Median $758.58 Typical High $1,230.27 | Professional | None | $363.08 | $758.58 | $1,230.27 |
Wellmark Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $1,047.13 | Professional | None | $575.44 | $676.08 | $1,047.13 |
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 $120.23 Median $181.97 Typical High $213.80 | Professional | 52 · Reduced service | $120.23 | $181.97 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $47.86 Median $72.44 Typical High $85.11 | Professional | 53 · Discontinued | $47.86 | $72.44 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $269.15 Typical High $323.59 | Professional | 54 · Surgery only | $181.97 | $269.15 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $54.95 Typical High $64.57 | Professional | 55 · Aftercare only | $36.31 | $54.95 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.99 Median $36.31 Typical High $42.66 | Professional | 56 · Pre-op care only | $23.99 | $36.31 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $251.19 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $169.82 | $251.19 | $302.00 |
Where South Dakota sits
The same service costs 5.9 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
$708
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.