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 $190.55 Median $213.80 Typical High $4,365.16 | Facility | None | $190.55 | $213.80 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $169.82 Median $194.98 Typical High $281.84 | Professional | None | $169.82 | $194.98 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $181.97 Typical High $407.38 | Facility | None | $123.03 | $181.97 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $467.74 Typical High $602.56 | Professional | None | $371.54 | $467.74 | $602.56 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $288.40 Typical High $467.74 | Facility | None | $125.89 | $288.40 | $467.74 |
Medica Setting Professional Modifier None Typical Low $199.53 Median $537.03 Typical High $1,621.81 | Professional | None | $199.53 | $537.03 | $1,621.81 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $489.78 | Professional | None | $436.52 | $436.52 | $489.78 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $218.78 | Facility | None | $123.03 | $173.78 | $218.78 |
Midlands Setting Professional Modifier None Typical Low $398.11 Median $426.58 Typical High $489.78 | Professional | None | $398.11 | $426.58 | $489.78 |
Sanford Health Plan Setting Professional Modifier None Typical Low $218.78 Median $338.84 Typical High $426.58 | Professional | None | $218.78 | $338.84 | $426.58 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $186.21 Median $426.58 Typical High $588.84 | Professional | None | $186.21 | $426.58 | $588.84 |
Wellmark Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $588.84 | Professional | None | $426.58 | $501.19 | $588.84 |
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 $85.11 Median $93.33 Typical High $112.20 | Professional | 52 · Reduced service | $85.11 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $37.15 Typical High $44.67 | Professional | 53 · Discontinued | $33.88 | $37.15 | $44.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $141.25 Typical High $169.82 | Professional | 54 · Surgery only | $125.89 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $28.18 Typical High $33.88 | Professional | 55 · Aftercare only | $25.12 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $18.62 Typical High $22.39 | Professional | 56 · Pre-op care only | $16.98 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $117.49 Median $131.83 Typical High $158.49 | Professional | 78 · Unplanned return to OR | $117.49 | $131.83 | $158.49 |
Where South Dakota sits
The same service costs 4.8 times more in Alaska than in Florida. 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· 5th of 51
$427
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.