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 $128.82 Median $239.88 Typical High $4,365.16 | Facility | None | $128.82 | $239.88 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $275.42 | Professional | None | $114.82 | $147.91 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $275.42 Typical High $457.09 | Facility | None | $213.80 | $275.42 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $416.87 Typical High $741.31 | Professional | None | $295.12 | $416.87 | $741.31 |
Medica Setting Facility Modifier None Typical Low $194.98 Median $371.54 Typical High $1,202.26 | Facility | None | $194.98 | $371.54 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $645.65 Typical High $1,862.09 | Professional | None | $208.93 | $645.65 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $295.12 Median $302.00 Typical High $537.03 | Professional | None | $295.12 | $302.00 | $537.03 |
Midlands Setting Facility Modifier None Typical Low $213.80 Median $257.04 Typical High $295.12 | Facility | None | $213.80 | $257.04 | $295.12 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $489.78 | Professional | None | $269.15 | $269.15 | $489.78 |
Sanford Health Plan Setting Professional Modifier None Typical Low $186.21 Median $295.12 Typical High $467.74 | Professional | None | $186.21 | $295.12 | $467.74 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $151.36 Median $354.81 Typical High $676.08 | Professional | None | $151.36 | $354.81 | $676.08 |
Wellmark Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $602.56 | Professional | None | $239.88 | $295.12 | $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 $57.54 Median $72.44 Typical High $138.04 | Professional | 52 · Reduced service | $57.54 | $72.44 | $138.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $29.51 Typical High $54.95 | Professional | 53 · Discontinued | $22.91 | $29.51 | $54.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $109.65 Typical High $204.17 | Professional | 54 · Surgery only | $87.10 | $109.65 | $204.17 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $21.88 Typical High $40.74 | Professional | 55 · Aftercare only | $17.38 | $21.88 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.79 Typical High $27.54 | Professional | 56 · Pre-op care only | $11.48 | $14.79 | $27.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $102.33 Typical High $190.55 | Professional | 78 · Unplanned return to OR | $81.28 | $102.33 | $190.55 |
Where South Dakota sits
The same service costs 4.3 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· 8th of 51
$355
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.