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 $117.49 Median $257.04 Typical High $4,365.16 | Facility | None | $117.49 | $257.04 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $234.42 Typical High $309.03 | Professional | None | $107.15 | $234.42 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $288.40 Typical High $501.19 | Facility | None | $213.80 | $288.40 | $501.19 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $446.68 Typical High $794.33 | Professional | None | $269.15 | $446.68 | $794.33 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $398.11 | Facility | None | $125.89 | $177.83 | $398.11 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $691.83 Typical High $1,995.26 | Professional | None | $223.87 | $691.83 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $281.84 Typical High $549.54 | Professional | None | $269.15 | $281.84 | $549.54 |
Midlands Setting Facility Modifier None Typical Low $213.80 Median $288.40 Typical High $346.74 | Facility | None | $213.80 | $288.40 | $346.74 |
Midlands Setting Professional Modifier None Typical Low $245.47 Median $245.47 Typical High $478.63 | Professional | None | $245.47 | $245.47 | $478.63 |
Sanford Health Plan Setting Professional Modifier None Typical Low $169.82 Median $281.84 Typical High $489.78 | Professional | None | $169.82 | $281.84 | $489.78 |
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 $141.25 Median $331.13 Typical High $724.44 | Professional | None | $141.25 | $331.13 | $724.44 |
Wellmark Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $660.69 | Professional | None | $223.87 | $275.42 | $660.69 |
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 $53.70 Median $67.61 Typical High $147.91 | Professional | 52 · Reduced service | $53.70 | $67.61 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $26.92 Typical High $58.88 | Professional | 53 · Discontinued | $21.38 | $26.92 | $58.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $100.00 Typical High $218.78 | Professional | 54 · Surgery only | $79.43 | $100.00 | $218.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $20.42 Typical High $44.67 | Professional | 55 · Aftercare only | $15.85 | $20.42 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.49 Typical High $29.51 | Professional | 56 · Pre-op care only | $10.72 | $13.49 | $29.51 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $93.33 Typical High $204.17 | Professional | 78 · Unplanned return to OR | $74.13 | $93.33 | $204.17 |
Where South Dakota sits
The same service costs 3.9 times more in Alaska than in Kentucky. 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· 7th of 51
$324
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.