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 $676.08 Median $912.01 Typical High $4,365.16 | Facility | None | $676.08 | $912.01 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $676.08 Typical High $794.33 | Professional | None | $575.44 | $676.08 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $3,019.95 Typical High $3,801.89 | Facility | None | $1,230.27 | $3,019.95 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,380.38 Median $1,778.28 Typical High $2,454.71 | Professional | None | $1,380.38 | $1,778.28 | $2,454.71 |
Medica Setting Facility Modifier None Typical Low $891.25 Median $1,348.96 Typical High $1,819.70 | Facility | None | $891.25 | $1,348.96 | $1,819.70 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $2,454.71 Typical High $6,918.31 | Professional | None | $812.83 | $2,454.71 | $6,918.31 |
Midlands Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,819.70 | Professional | None | $1,412.54 | $1,412.54 | $1,819.70 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $3,019.95 Typical High $4,073.80 | Facility | None | $1,096.48 | $3,019.95 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $1,288.25 Median $1,288.25 Typical High $1,659.59 | Professional | None | $1,288.25 | $1,288.25 | $1,659.59 |
Sanford Health Plan Setting Professional Modifier None Typical Low $891.25 Median $1,202.26 Typical High $1,621.81 | Professional | None | $891.25 | $1,202.26 | $1,621.81 |
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 $758.58 Median $1,778.28 Typical High $2,570.40 | Professional | None | $758.58 | $1,778.28 | $2,570.40 |
Wellmark Setting Professional Modifier None Typical Low $1,202.26 Median $1,380.38 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,380.38 | $2,137.96 |
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 $288.40 Median $338.84 Typical High $398.11 | Professional | 52 · Reduced service | $288.40 | $338.84 | $398.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $134.90 Typical High $158.49 | Professional | 53 · Discontinued | $114.82 | $134.90 | $158.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $512.86 Typical High $602.56 | Professional | 54 · Surgery only | $426.58 | $512.86 | $602.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87.10 Median $102.33 Typical High $120.23 | Professional | 55 · Aftercare only | $87.10 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $67.61 Typical High $79.43 | Professional | 56 · Pre-op care only | $57.54 | $67.61 | $79.43 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $478.63 Typical High $562.34 | Professional | 78 · Unplanned return to OR | $398.11 | $478.63 | $562.34 |
Where South Dakota sits
The same service costs 5.2 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· 8th of 51
$1,413
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.