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 $363.08 Median $524.81 Typical High $4,365.16 | Facility | None | $363.08 | $524.81 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $323.59 Median $467.74 Typical High $616.60 | Professional | None | $323.59 | $467.74 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $1,071.52 Typical High $1,737.80 | Facility | None | $794.33 | $1,071.52 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,096.48 Typical High $1,584.89 | Professional | None | $776.25 | $1,096.48 | $1,584.89 |
Medica Setting Facility Modifier None Typical Low $537.03 Median $776.25 Typical High $1,202.26 | Facility | None | $537.03 | $776.25 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $457.09 Median $1,258.93 Typical High $3,981.07 | Professional | None | $457.09 | $1,258.93 | $3,981.07 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $851.14 Typical High $1,174.90 | Professional | None | $831.76 | $851.14 | $1,174.90 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,071.52 Typical High $1,995.26 | Facility | None | $954.99 | $1,071.52 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $1,071.52 | Professional | None | $758.58 | $758.58 | $1,071.52 |
Sanford Health Plan Setting Professional Modifier None Typical Low $549.54 Median $724.44 Typical High $1,000.00 | Professional | None | $549.54 | $724.44 | $1,000.00 |
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 $426.58 Median $912.01 Typical High $1,445.44 | Professional | None | $426.58 | $912.01 | $1,445.44 |
Wellmark Setting Professional Modifier None Typical Low $741.31 Median $851.14 Typical High $1,348.96 | Professional | None | $741.31 | $851.14 | $1,348.96 |
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 $162.18 Median $229.09 Typical High $309.03 | Professional | 52 · Reduced service | $162.18 | $229.09 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $64.57 Median $93.33 Typical High $123.03 | Professional | 53 · Discontinued | $64.57 | $93.33 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $239.88 Median $346.74 Typical High $467.74 | Professional | 54 · Surgery only | $239.88 | $346.74 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $47.86 Median $69.18 Typical High $93.33 | Professional | 55 · Aftercare only | $47.86 | $69.18 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $32.36 Median $46.77 Typical High $61.66 | Professional | 56 · Pre-op care only | $32.36 | $46.77 | $61.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $223.87 Median $323.59 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $223.87 | $323.59 | $436.52 |
Where South Dakota sits
The same service costs 4.4 times more in Alaska than in Texas. 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
$871
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.