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 $1,096.48 Median $4,365.16 Typical High $4,897.79 | Facility | None | $1,096.48 | $4,365.16 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $912.01 Median $912.01 Typical High $1,096.48 | Professional | None | $912.01 | $912.01 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $3,019.95 Typical High $3,801.89 | Facility | None | $1,548.82 | $3,019.95 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,737.80 Median $2,511.89 Typical High $3,090.30 | Professional | None | $1,737.80 | $2,511.89 | $3,090.30 |
Medica Setting Facility Modifier None Typical Low $1,348.96 Median $2,511.89 Typical High $3,311.31 | Facility | None | $1,348.96 | $2,511.89 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $2,511.89 Typical High $11,481.54 | Professional | None | $1,122.02 | $2,511.89 | $11,481.54 |
Midlands Setting Professional Modifier None Typical Low $2,398.83 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,398.83 | $2,511.89 | $2,511.89 |
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 $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,548.82 | $2,089.30 |
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 $1,047.13 Median $2,041.74 Typical High $3,019.95 | Professional | None | $1,047.13 | $2,041.74 | $3,019.95 |
Wellmark Setting Professional Modifier None Typical Low $2,137.96 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,137.96 | $2,454.71 | $2,454.71 |
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 $457.09 Median $457.09 Typical High $549.54 | Professional | 52 · Reduced service | $457.09 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $181.97 Typical High $218.78 | Professional | 53 · Discontinued | $181.97 | $181.97 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $676.08 Median $676.08 Typical High $812.83 | Professional | 54 · Surgery only | $676.08 | $676.08 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $134.90 Median $134.90 Typical High $165.96 | Professional | 55 · Aftercare only | $134.90 | $134.90 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $91.20 Typical High $109.65 | Professional | 56 · Pre-op care only | $91.20 | $91.20 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $630.96 | $630.96 | $758.58 |
Where South Dakota sits
The same service costs 6.2 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· 5th of 51
$2,399
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.