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 $457.09 Typical High $4,365.16 | Facility | None | $295.12 | $457.09 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $457.09 | Professional | None | $263.03 | $407.38 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $338.84 Median $524.81 Typical High $891.25 | Facility | None | $338.84 | $524.81 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $524.81 Median $870.96 Typical High $1,202.26 | Professional | None | $524.81 | $870.96 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $380.19 Median $691.83 Typical High $3,019.95 | Facility | None | $380.19 | $691.83 | $3,019.95 |
Medica Setting Professional Modifier None Typical Low $416.87 Median $891.25 Typical High $3,467.37 | Professional | None | $416.87 | $891.25 | $3,467.37 |
Midlands Setting Professional Modifier None Typical Low $616.60 Median $741.31 Typical High $891.25 | Professional | None | $616.60 | $741.31 | $891.25 |
Midlands Setting Facility Modifier None Typical Low $338.84 Median $436.52 Typical High $645.65 | Facility | None | $338.84 | $436.52 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $524.81 Median $524.81 Typical High $741.31 | Professional | None | $524.81 | $524.81 | $741.31 |
Sanford Health Plan Setting Professional Modifier None Typical Low $416.87 Median $575.44 Typical High $870.96 | Professional | None | $416.87 | $575.44 | $870.96 |
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 $323.59 Median $660.69 Typical High $1,258.93 | Professional | None | $323.59 | $660.69 | $1,258.93 |
Wellmark Setting Professional Modifier None Typical Low $660.69 Median $758.58 Typical High $1,318.26 | Professional | None | $660.69 | $758.58 | $1,318.26 |
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 $131.83 Median $204.17 Typical High $229.09 | Professional | 52 · Reduced service | $131.83 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $52.48 Median $81.28 Typical High $91.20 | Professional | 53 · Discontinued | $52.48 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $199.53 Median $309.03 Typical High $346.74 | Professional | 54 · Surgery only | $199.53 | $309.03 | $346.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $39.81 Median $61.66 Typical High $69.18 | Professional | 55 · Aftercare only | $39.81 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $26.30 Median $40.74 Typical High $45.71 | Professional | 56 · Pre-op care only | $26.30 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $186.21 Median $288.40 Typical High $323.59 | Professional | 78 · Unplanned return to OR | $186.21 | $288.40 | $323.59 |
Where South Dakota sits
The same service costs 4.3 times more in Alaska than in Kentucky. 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· 5th of 51
$759
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.