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 $204.17 Median $218.78 Typical High $4,365.16 | Facility | None | $204.17 | $218.78 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $173.78 Median $194.98 Typical High $269.15 | Professional | None | $173.78 | $194.98 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $416.87 | Facility | None | $123.03 | $173.78 | $416.87 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $676.08 | Professional | None | $380.19 | $501.19 | $676.08 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $309.03 Typical High $501.19 | Facility | None | $125.89 | $309.03 | $501.19 |
Medica Setting Professional Modifier None Typical Low $204.17 Median $549.54 Typical High $1,659.59 | Professional | None | $204.17 | $549.54 | $1,659.59 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $501.19 | Professional | None | $467.74 | $467.74 | $501.19 |
Midlands Setting Facility Modifier None Typical Low $123.03 Median $162.18 Typical High $218.78 | Facility | None | $123.03 | $162.18 | $218.78 |
Midlands Setting Professional Modifier None Typical Low $407.38 Median $446.68 Typical High $489.78 | Professional | None | $407.38 | $446.68 | $489.78 |
Sanford Health Plan Setting Professional Modifier None Typical Low $234.42 Median $363.08 Typical High $457.09 | Professional | None | $234.42 | $363.08 | $457.09 |
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 $190.55 Median $436.52 Typical High $616.60 | Professional | None | $190.55 | $436.52 | $616.60 |
Wellmark Setting Professional Modifier None Typical Low $457.09 Median $512.86 Typical High $602.56 | Professional | None | $457.09 | $512.86 | $602.56 |
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 $91.20 Median $95.50 Typical High $114.82 | Professional | 52 · Reduced service | $91.20 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $38.90 Typical High $45.71 | Professional | 53 · Discontinued | $36.31 | $38.90 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $144.54 Typical High $173.78 | Professional | 54 · Surgery only | $134.90 | $144.54 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $28.84 Typical High $34.67 | Professional | 55 · Aftercare only | $27.54 | $28.84 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $19.50 Typical High $22.91 | Professional | 56 · Pre-op care only | $18.20 | $19.50 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $134.90 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $125.89 | $134.90 | $162.18 |
Where South Dakota sits
The same service costs 5.1 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· 5th of 51
$447
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.