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 $151.36 Median $181.97 Typical High $4,365.16 | Facility | None | $151.36 | $181.97 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $131.83 Median $158.49 Typical High $234.42 | Professional | None | $131.83 | $158.49 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $173.78 Typical High $346.74 | Facility | None | $123.03 | $173.78 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $371.54 Typical High $467.74 | Professional | None | $295.12 | $371.54 | $467.74 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $223.87 Typical High $363.08 | Facility | None | $125.89 | $223.87 | $363.08 |
Medica Setting Professional Modifier None Typical Low $158.49 Median $446.68 Typical High $1,380.38 | Professional | None | $158.49 | $446.68 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $416.87 | Professional | None | $346.74 | $346.74 | $416.87 |
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 $309.03 Median $338.84 Typical High $407.38 | Professional | None | $309.03 | $338.84 | $407.38 |
Sanford Health Plan Setting Professional Modifier None Typical Low $181.97 Median $269.15 Typical High $363.08 | Professional | None | $181.97 | $269.15 | $363.08 |
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 $154.88 Median $354.81 Typical High $501.19 | Professional | None | $154.88 | $354.81 | $501.19 |
Wellmark Setting Professional Modifier None Typical Low $331.13 Median $398.11 Typical High $501.19 | Professional | None | $331.13 | $398.11 | $501.19 |
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 $66.07 Median $79.43 Typical High $95.50 | Professional | 52 · Reduced service | $66.07 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $31.62 Typical High $38.90 | Professional | 53 · Discontinued | $26.30 | $31.62 | $38.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $120.23 Typical High $144.54 | Professional | 54 · Surgery only | $100.00 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $23.99 Typical High $28.84 | Professional | 55 · Aftercare only | $19.95 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $15.85 Typical High $19.05 | Professional | 56 · Pre-op care only | $13.18 | $15.85 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $112.20 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $93.33 | $112.20 | $134.90 |
Where South Dakota sits
The same service costs 4.6 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· 6th of 51
$347
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.