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 $323.59 Median $1,513.56 Typical High $4,365.16 | Facility | None | $323.59 | $1,513.56 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $316.23 Median $354.81 Typical High $1,621.81 | Professional | None | $316.23 | $354.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $2,089.30 Typical High $2,570.40 | Facility | None | $1,621.81 | $2,089.30 | $2,570.40 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $933.25 Typical High $4,168.69 | Professional | None | $741.31 | $933.25 | $4,168.69 |
Medica Setting Facility Modifier None Typical Low $537.03 Median $1,995.26 Typical High $2,454.71 | Facility | None | $537.03 | $1,995.26 | $2,454.71 |
Medica Setting Professional Modifier None Typical Low $1,288.25 Median $3,981.07 Typical High $10,471.29 | Professional | None | $1,288.25 | $3,981.07 | $10,471.29 |
Midlands Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $3,235.94 | Professional | None | $741.31 | $741.31 | $3,235.94 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,621.81 Typical High $2,187.76 | Facility | None | $1,096.48 | $1,621.81 | $2,187.76 |
Sanford Health Plan Setting Professional Modifier None Typical Low $537.03 Median $1,778.28 Typical High $2,570.40 | Professional | None | $537.03 | $1,778.28 | $2,570.40 |
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 $371.54 Median $891.25 Typical High $4,168.69 | Professional | None | $371.54 | $891.25 | $4,168.69 |
Wellmark Setting Professional Modifier None Typical Low $660.69 Median $812.83 Typical High $4,073.80 | Professional | None | $660.69 | $812.83 | $4,073.80 |
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 $158.49 Median $177.83 Typical High $794.33 | Professional | 52 · Reduced service | $158.49 | $177.83 | $794.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $70.79 Typical High $323.59 | Professional | 53 · Discontinued | $64.57 | $70.79 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $269.15 Typical High $1,202.26 | Professional | 54 · Surgery only | $239.88 | $269.15 | $1,202.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $53.70 Typical High $239.88 | Professional | 55 · Aftercare only | $47.86 | $53.70 | $239.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $31.62 Median $35.48 Typical High $162.18 | Professional | 56 · Pre-op care only | $31.62 | $35.48 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $251.19 Typical High $1,122.02 | Professional | 78 · Unplanned return to OR | $223.87 | $251.19 | $1,122.02 |
Where South Dakota sits
The same service costs 5.8 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· 14th of 51
$1,778
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.