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 $660.69 Median $831.76 Typical High $4,365.16 | Facility | None | $660.69 | $831.76 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $575.44 Median $741.31 Typical High $831.76 | Professional | None | $575.44 | $741.31 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,258.93 Median $1,584.89 Typical High $3,801.89 | Facility | None | $1,258.93 | $1,584.89 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,230.27 Median $1,659.59 Typical High $2,137.96 | Professional | None | $1,230.27 | $1,659.59 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $1,258.93 Typical High $1,819.70 | Facility | None | $977.24 | $1,258.93 | $1,819.70 |
Medica Setting Professional Modifier None Typical Low $977.24 Median $1,862.09 Typical High $6,456.54 | Professional | None | $977.24 | $1,862.09 | $6,456.54 |
Midlands Setting Professional Modifier None Typical Low $1,513.56 Median $1,698.24 Typical High $1,862.09 | Professional | None | $1,513.56 | $1,698.24 | $1,862.09 |
Midlands Setting Facility Modifier None Typical Low $1,288.25 Median $1,659.59 Typical High $4,073.80 | Facility | None | $1,288.25 | $1,659.59 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,698.24 | Professional | None | $1,380.38 | $1,380.38 | $1,698.24 |
Sanford Health Plan Setting Professional Modifier None Typical Low $870.96 Median $1,230.27 Typical High $1,659.59 | Professional | None | $870.96 | $1,230.27 | $1,659.59 |
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 $758.58 Median $1,380.38 Typical High $2,290.87 | Professional | None | $758.58 | $1,380.38 | $2,290.87 |
Wellmark Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $2,187.76 | Professional | None | $1,288.25 | $1,513.56 | $2,187.76 |
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 $288.40 Median $371.54 Typical High $416.87 | Professional | 52 · Reduced service | $288.40 | $371.54 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114.82 Median $147.91 Typical High $165.96 | Professional | 53 · Discontinued | $114.82 | $147.91 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $426.58 Median $562.34 Typical High $630.96 | Professional | 54 · Surgery only | $426.58 | $562.34 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $112.20 Typical High $125.89 | Professional | 55 · Aftercare only | $85.11 | $112.20 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57.54 Median $74.13 Typical High $83.18 | Professional | 56 · Pre-op care only | $57.54 | $74.13 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $398.11 Median $524.81 Typical High $588.84 | Professional | 78 · Unplanned return to OR | $398.11 | $524.81 | $588.84 |
Where South Dakota sits
The same service costs 4.4 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· 5th of 51
$1,514
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.