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 $169.82 Median $269.15 Typical High $4,365.16 | Facility | None | $169.82 | $269.15 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $309.03 | Professional | None | $138.04 | $218.78 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $245.47 Median $288.40 Typical High $467.74 | Facility | None | $245.47 | $288.40 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $478.63 Typical High $616.60 | Professional | None | $338.84 | $478.63 | $616.60 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $371.54 Typical High $1,202.26 | Facility | None | $234.42 | $371.54 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $302.00 Median $616.60 Typical High $1,862.09 | Professional | None | $302.00 | $616.60 | $1,862.09 |
Midlands Setting Professional Modifier None Typical Low $398.11 Median $407.38 Typical High $616.60 | Professional | None | $398.11 | $407.38 | $616.60 |
Midlands Setting Facility Modifier None Typical Low $245.47 Median $263.03 Typical High $331.13 | Facility | None | $245.47 | $263.03 | $331.13 |
Midlands Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $549.54 | Professional | None | $354.81 | $354.81 | $549.54 |
Sanford Health Plan Setting Professional Modifier None Typical Low $234.42 Median $338.84 Typical High $478.63 | Professional | None | $234.42 | $338.84 | $478.63 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $213.80 Median $416.87 Typical High $758.58 | Professional | None | $213.80 | $416.87 | $758.58 |
Wellmark Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $660.69 | Professional | None | $331.13 | $380.19 | $660.69 |
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 $69.18 Median $109.65 Typical High $123.03 | Professional | 52 · Reduced service | $69.18 | $109.65 | $123.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $43.65 Typical High $48.98 | Professional | 53 · Discontinued | $27.54 | $43.65 | $48.98 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $165.96 Typical High $186.21 | Professional | 54 · Surgery only | $104.71 | $165.96 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $33.11 Typical High $37.15 | Professional | 55 · Aftercare only | $20.89 | $33.11 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $21.88 Typical High $24.55 | Professional | 56 · Pre-op care only | $13.80 | $21.88 | $24.55 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $154.88 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $97.72 | $154.88 | $173.78 |
Where South Dakota sits
The same service costs 3.6 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· 8th of 51
$398
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.