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 $295.12 Median $389.05 Typical High $4,365.16 | Facility | None | $295.12 | $389.05 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $245.47 Median $323.59 Typical High $758.58 | Professional | None | $245.47 | $323.59 | $758.58 |
Cigna Setting Facility Modifier None Typical Low $562.34 Median $1,445.44 Typical High $1,737.80 | Facility | None | $562.34 | $1,445.44 | $1,737.80 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,122.02 | Professional | None | $630.96 | $851.14 | $1,122.02 |
Medica Setting Facility Modifier None Typical Low $416.87 Median $549.54 Typical High $1,698.24 | Facility | None | $416.87 | $549.54 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $346.74 Median $1,023.29 Typical High $2,754.23 | Professional | None | $346.74 | $1,023.29 | $2,754.23 |
Midlands Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $891.25 | Professional | None | $691.83 | $691.83 | $891.25 |
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 $602.56 Median $602.56 Typical High $794.33 | Professional | None | $602.56 | $602.56 | $794.33 |
Sanford Health Plan Setting Professional Modifier None Typical Low $389.05 Median $562.34 Typical High $724.44 | Professional | None | $389.05 | $562.34 | $724.44 |
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 $338.84 Median $794.33 Typical High $1,071.52 | Professional | None | $338.84 | $794.33 | $1,071.52 |
Wellmark Setting Professional Modifier None Typical Low $588.84 Median $676.08 Typical High $977.24 | Professional | None | $588.84 | $676.08 | $977.24 |
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 $123.03 Median $147.91 Typical High $181.97 | Professional | 52 · Reduced service | $123.03 | $147.91 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $58.88 Typical High $72.44 | Professional | 53 · Discontinued | $48.98 | $58.88 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $181.97 Median $223.87 Typical High $275.42 | Professional | 54 · Surgery only | $181.97 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $44.67 Typical High $54.95 | Professional | 55 · Aftercare only | $37.15 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $29.51 Typical High $36.31 | Professional | 56 · Pre-op care only | $24.55 | $29.51 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $169.82 Median $208.93 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $169.82 | $208.93 | $257.04 |
Where South Dakota sits
The same service costs 4.9 times more in Alaska than in Utah. 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
$692
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.