How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $2,754.23 Median $2,754.23 Typical High $4,365.16 | Facility | None | $2,754.23 | $2,754.23 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,754.23 | Professional | None | $2,344.23 | $2,344.23 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $4,897.79 | Facility | None | $3,981.07 | $3,981.07 | $4,897.79 |
Cigna Setting Professional Modifier None Typical Low $4,466.84 Median $6,309.57 Typical High $7,943.28 | Professional | None | $4,466.84 | $6,309.57 | $7,943.28 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $3,311.31 Typical High $3,890.45 | Facility | None | $758.58 | $3,311.31 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $2,818.38 Median $6,309.57 Typical High $20,417.38 | Professional | None | $2,818.38 | $6,309.57 | $20,417.38 |
Midlands Setting Professional Modifier None Typical Low $6,025.60 Median $6,309.57 Typical High $6,309.57 | Professional | None | $6,025.60 | $6,309.57 | $6,309.57 |
Midlands Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
Sanford Health Plan Setting Professional Modifier None Typical Low $2,951.21 Median $3,981.07 Typical High $5,248.07 | Professional | None | $2,951.21 | $3,981.07 | $5,248.07 |
United Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $1,202.26 | Facility | None | $758.58 | $758.58 | $1,202.26 |
United Setting Professional Modifier None Typical Low $2,630.27 Median $5,495.41 Typical High $7,585.78 | Professional | None | $2,630.27 | $5,495.41 | $7,585.78 |
Wellmark Setting Professional Modifier None Typical Low $5,370.32 Median $6,165.95 Typical High $6,165.95 | Professional | None | $5,370.32 | $6,165.95 | $6,165.95 |
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 $1,174.90 Median $1,174.90 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $549.54 | Professional | 53 · Discontinued | $467.74 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,737.80 Median $1,737.80 Typical High $2,041.74 | Professional | 54 · Surgery only | $1,737.80 | $1,737.80 | $2,041.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $346.74 Median $346.74 Typical High $416.87 | Professional | 55 · Aftercare only | $346.74 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $275.42 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,621.81 Median $1,621.81 Typical High $1,905.46 | Professional | 78 · Unplanned return to OR | $1,621.81 | $1,621.81 | $1,905.46 |
Where South Dakota sits
The same service costs 22.9 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· 4th of 51
$5,623
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.