How much rates vary
Facilitymedian $1,445 · 10th to 90th $589 to $1,820Professionalmedian $933 · 10th to 90th $490 to $1,445
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 $398.11 Median $549.54 Typical High $4,365.16 | Facility | None | $398.11 | $549.54 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $346.74 Median $478.63 Typical High $575.44 | Professional | None | $346.74 | $478.63 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,445.44 Typical High $1,737.80 | Facility | None | $812.83 | $1,445.44 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,621.81 | Professional | None | $831.76 | $1,174.90 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $588.84 Median $812.83 Typical High $1,698.24 | Facility | None | $588.84 | $812.83 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $524.81 Median $1,348.96 Typical High $4,168.69 | Professional | None | $524.81 | $1,348.96 | $4,168.69 |
Midlands Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,230.27 | Professional | None | $912.01 | $912.01 | $1,230.27 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,479.11 Typical High $1,995.26 | Facility | None | $954.99 | $1,479.11 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $1,122.02 | Professional | None | $831.76 | $831.76 | $1,122.02 |
Sanford Health Plan Setting Professional Modifier None Typical Low $588.84 Median $794.33 Typical High $1,047.13 | Professional | None | $588.84 | $794.33 | $1,047.13 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,513.56 | $1,513.56 | $1,819.70 |
United Setting Professional Modifier None Typical Low $457.09 Median $954.99 Typical High $1,513.56 | Professional | None | $457.09 | $954.99 | $1,513.56 |
Wellmark Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $1,445.44 | Professional | None | $812.83 | $933.25 | $1,445.44 |
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 $173.78 Median $239.88 Typical High $338.84 | Professional | 52 · Reduced service | $173.78 | $239.88 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $95.50 Typical High $134.90 | Professional | 53 · Discontinued | $69.18 | $95.50 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $363.08 Typical High $512.86 | Professional | 54 · Surgery only | $263.03 | $363.08 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $72.44 Typical High $102.33 | Professional | 55 · Aftercare only | $52.48 | $72.44 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $47.86 Typical High $67.61 | Professional | 56 · Pre-op care only | $34.67 | $47.86 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $338.84 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $245.47 | $338.84 | $478.63 |
Where South Dakota sits
The same service costs 4.6 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $6,614MT $1,440
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.