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 $102.33 Median $117.49 Typical High $4,365.16 | Facility | None | $102.33 | $117.49 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $104.71 Typical High $125.89 | Professional | None | $91.20 | $104.71 | $125.89 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $114.82 Typical High $229.09 | Facility | None | $93.33 | $114.82 | $229.09 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $257.04 Typical High $323.59 | Professional | None | $204.17 | $257.04 | $323.59 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $151.36 Typical High $245.47 | Facility | None | $125.89 | $151.36 | $245.47 |
Medica Setting Professional Modifier None Typical Low $104.71 Median $288.40 Typical High $891.25 | Professional | None | $104.71 | $288.40 | $891.25 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $269.15 | Professional | None | $239.88 | $239.88 | $269.15 |
Midlands Setting Facility Modifier None Typical Low $93.33 Median $112.20 Typical High $134.90 | Facility | None | $93.33 | $112.20 | $134.90 |
Midlands Setting Professional Modifier None Typical Low $208.93 Median $229.09 Typical High $263.03 | Professional | None | $208.93 | $229.09 | $263.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $117.49 Median $186.21 Typical High $239.88 | Professional | None | $117.49 | $186.21 | $239.88 |
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 $102.33 Median $234.42 Typical High $323.59 | Professional | None | $102.33 | $234.42 | $323.59 |
Wellmark Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $316.23 | Professional | None | $223.87 | $263.03 | $316.23 |
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 $45.71 Median $52.48 Typical High $63.10 | Professional | 52 · Reduced service | $45.71 | $52.48 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $20.89 Typical High $25.12 | Professional | 53 · Discontinued | $18.20 | $20.89 | $25.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $67.61 Median $77.62 Typical High $93.33 | Professional | 54 · Surgery only | $67.61 | $77.62 | $93.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $15.49 Typical High $19.05 | Professional | 55 · Aftercare only | $13.49 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $10.47 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.12 | $10.47 | $12.59 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $63.10 Median $72.44 Typical High $87.10 | Professional | 78 · Unplanned return to OR | $63.10 | $72.44 | $87.10 |
Where South Dakota sits
The same service costs 4.5 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
$234
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.