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 $1,174.90 Median $1,479.11 Typical High $4,897.79 | Facility | None | $1,174.90 | $1,479.11 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $1,000.00 Median $1,174.90 Typical High $1,445.44 | Professional | None | $1,000.00 | $1,174.90 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $2,187.76 Median $3,019.95 Typical High $3,801.89 | Facility | None | $2,187.76 | $3,019.95 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $2,511.89 Median $3,090.30 Typical High $4,365.16 | Professional | None | $2,511.89 | $3,090.30 | $4,365.16 |
Medica Setting Facility Modifier None Typical Low $1,621.81 Median $2,187.76 Typical High $3,311.31 | Facility | None | $1,621.81 | $2,187.76 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $1,318.26 Median $3,981.07 Typical High $11,220.18 | Professional | None | $1,318.26 | $3,981.07 | $11,220.18 |
Midlands Setting Professional Modifier None Typical Low $2,511.89 Median $2,630.27 Typical High $3,090.30 | Professional | None | $2,511.89 | $2,630.27 | $3,090.30 |
Midlands Setting Facility Modifier None Typical Low $1,380.38 Median $3,019.95 Typical High $4,073.80 | Facility | None | $1,380.38 | $3,019.95 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,754.23 | Professional | None | $2,290.87 | $2,290.87 | $2,754.23 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,584.89 Median $2,187.76 Typical High $2,818.38 | Professional | None | $1,584.89 | $2,187.76 | $2,818.38 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,311.31 | Facility | None | $2,818.38 | $2,818.38 | $3,311.31 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $3,162.28 Typical High $4,168.69 | Professional | None | $1,258.93 | $3,162.28 | $4,168.69 |
Wellmark Setting Professional Modifier None Typical Low $2,344.23 Median $2,691.53 Typical High $4,168.69 | Professional | None | $2,344.23 | $2,691.53 | $4,168.69 |
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 $501.19 Median $588.84 Typical High $724.44 | Professional | 52 · Reduced service | $501.19 | $588.84 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $199.53 Median $234.42 Typical High $288.40 | Professional | 53 · Discontinued | $199.53 | $234.42 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $741.31 Median $891.25 Typical High $1,071.52 | Professional | 54 · Surgery only | $741.31 | $891.25 | $1,071.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $177.83 Typical High $213.80 | Professional | 55 · Aftercare only | $147.91 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $100.00 Median $117.49 Typical High $144.54 | Professional | 56 · Pre-op care only | $100.00 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $691.83 Median $831.76 Typical High $1,000.00 | Professional | 78 · Unplanned return to OR | $691.83 | $831.76 | $1,000.00 |
Where South Dakota sits
The same service costs 5.2 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· 6th of 51
$2,692
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.