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 $338.84 Median $467.74 Typical High $4,365.16 | Facility | None | $338.84 | $467.74 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $281.84 Median $389.05 Typical High $489.78 | Professional | None | $281.84 | $389.05 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $660.69 Median $3,019.95 Typical High $3,801.89 | Facility | None | $660.69 | $3,019.95 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $912.01 Typical High $1,202.26 | Professional | None | $630.96 | $912.01 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $645.65 Typical High $1,698.24 | Facility | None | $467.74 | $645.65 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $512.86 Median $1,071.52 Typical High $3,311.31 | Professional | None | $512.86 | $1,071.52 | $3,311.31 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $831.76 Typical High $1,071.52 | Professional | None | $794.33 | $831.76 | $1,071.52 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $3,019.95 Typical High $4,073.80 | Facility | None | $954.99 | $3,019.95 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $707.95 Median $707.95 Typical High $954.99 | Professional | None | $707.95 | $707.95 | $954.99 |
Sanford Health Plan Setting Professional Modifier None Typical Low $467.74 Median $616.60 Typical High $851.14 | Professional | None | $467.74 | $616.60 | $851.14 |
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 $407.38 Median $724.44 Typical High $1,318.26 | Professional | None | $407.38 | $724.44 | $1,318.26 |
Wellmark Setting Professional Modifier None Typical Low $676.08 Median $776.25 Typical High $1,202.26 | Professional | None | $676.08 | $776.25 | $1,202.26 |
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 $138.04 Median $194.98 Typical High $218.78 | Professional | 52 · Reduced service | $138.04 | $194.98 | $218.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $77.62 Typical High $87.10 | Professional | 53 · Discontinued | $56.23 | $77.62 | $87.10 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $208.93 Median $288.40 Typical High $323.59 | Professional | 54 · Surgery only | $208.93 | $288.40 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $57.54 Typical High $66.07 | Professional | 55 · Aftercare only | $41.69 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $38.90 Typical High $43.65 | Professional | 56 · Pre-op care only | $28.18 | $38.90 | $43.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $194.98 Median $269.15 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $194.98 | $269.15 | $302.00 |
Where South Dakota sits
The same service costs 4.0 times more in Alaska than in New Jersey. 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
$794
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.