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 $371.54 Median $1,318.26 Typical High $4,365.16 | Facility | None | $371.54 | $1,318.26 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $371.54 Median $407.38 Typical High $1,348.96 | Professional | None | $371.54 | $407.38 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $2,041.74 Typical High $2,187.76 | Facility | None | $1,737.80 | $2,041.74 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,995.26 Typical High $3,467.37 | Professional | None | $851.14 | $1,995.26 | $3,467.37 |
Medica Setting Facility Modifier None Typical Low $616.60 Median $1,995.26 Typical High $2,398.83 | Facility | None | $616.60 | $1,995.26 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $1,148.15 Median $3,548.13 Typical High $8,912.51 | Professional | None | $1,148.15 | $3,548.13 | $8,912.51 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $2,951.21 | Professional | None | $851.14 | $851.14 | $2,951.21 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $2,041.74 Typical High $2,187.76 | Facility | None | $1,096.48 | $2,041.74 | $2,187.76 |
Sanford Health Plan Setting Professional Modifier None Typical Low $616.60 Median $1,445.44 Typical High $2,187.76 | Professional | None | $616.60 | $1,445.44 | $2,187.76 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Facility | None | $1,995.26 | $1,995.26 | $2,398.83 |
United Setting Professional Modifier None Typical Low $407.38 Median $1,023.29 Typical High $3,715.35 | Professional | None | $407.38 | $1,023.29 | $3,715.35 |
Wellmark Setting Professional Modifier None Typical Low $758.58 Median $933.25 Typical High $3,467.37 | Professional | None | $758.58 | $933.25 | $3,467.37 |
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 $181.97 Median $204.17 Typical High $676.08 | Professional | 52 · Reduced service | $181.97 | $204.17 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $74.13 Median $81.28 Typical High $269.15 | Professional | 53 · Discontinued | $74.13 | $81.28 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $275.42 Median $309.03 Typical High $1,023.29 | Professional | 54 · Surgery only | $275.42 | $309.03 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $54.95 Median $61.66 Typical High $204.17 | Professional | 55 · Aftercare only | $54.95 | $61.66 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $37.15 Median $40.74 Typical High $134.90 | Professional | 56 · Pre-op care only | $37.15 | $40.74 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $257.04 Median $288.40 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $257.04 | $288.40 | $954.99 |
Where South Dakota sits
The same service costs 4.4 times more in Alaska than in Nebraska. 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· 11th of 51
$1,622
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.