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 $107.15 Median $181.97 Typical High $4,365.16 | Facility | None | $107.15 | $181.97 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $154.88 Typical High $204.17 | Professional | None | $95.50 | $154.88 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $173.78 Typical High $346.74 | Facility | None | $162.18 | $173.78 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $239.88 Median $331.13 Typical High $549.54 | Professional | None | $239.88 | $331.13 | $549.54 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $275.42 | Facility | None | $125.89 | $162.18 | $275.42 |
Medica Setting Professional Modifier None Typical Low $165.96 Median $489.78 Typical High $1,380.38 | Professional | None | $165.96 | $489.78 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $251.19 Typical High $416.87 | Professional | None | $239.88 | $251.19 | $416.87 |
Midlands Setting Facility Modifier None Typical Low $158.49 Median $173.78 Typical High $229.09 | Facility | None | $158.49 | $173.78 | $229.09 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $371.54 | Professional | None | $218.78 | $218.78 | $371.54 |
Sanford Health Plan Setting Professional Modifier None Typical Low $154.88 Median $245.47 Typical High $363.08 | Professional | None | $154.88 | $245.47 | $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 $125.89 Median $295.12 Typical High $512.86 | Professional | None | $125.89 | $295.12 | $512.86 |
Wellmark Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $457.09 | Professional | None | $204.17 | $251.19 | $457.09 |
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 $47.86 Median $61.66 Typical High $102.33 | Professional | 52 · Reduced service | $47.86 | $61.66 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $24.55 Typical High $41.69 | Professional | 53 · Discontinued | $19.05 | $24.55 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $91.20 Typical High $154.88 | Professional | 54 · Surgery only | $72.44 | $91.20 | $154.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $18.20 Typical High $30.90 | Professional | 55 · Aftercare only | $14.45 | $18.20 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.30 Typical High $20.42 | Professional | 56 · Pre-op care only | $9.55 | $12.30 | $20.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $85.11 Typical High $144.54 | Professional | 78 · Unplanned return to OR | $67.61 | $85.11 | $144.54 |
Where South Dakota sits
The same service costs 4.5 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
$263
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.