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 $109.65 Median $181.97 Typical High $4,365.16 | Facility | None | $109.65 | $181.97 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $154.88 Typical High $169.82 | Professional | None | $93.33 | $154.88 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $177.83 Typical High $331.13 | Facility | None | $131.83 | $177.83 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $323.59 Typical High $501.19 | Professional | None | $213.80 | $323.59 | $501.19 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $186.21 Typical High $263.03 | Facility | None | $125.89 | $186.21 | $263.03 |
Medica Setting Professional Modifier None Typical Low $181.97 Median $407.38 Typical High $1,318.26 | Professional | None | $181.97 | $407.38 | $1,318.26 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $275.42 Typical High $407.38 | Professional | None | $257.04 | $275.42 | $407.38 |
Midlands Setting Facility Modifier None Typical Low $131.83 Median $173.78 Typical High $204.17 | Facility | None | $131.83 | $173.78 | $204.17 |
Midlands Setting Professional Modifier None Typical Low $223.87 Median $223.87 Typical High $363.08 | Professional | None | $223.87 | $223.87 | $363.08 |
Sanford Health Plan Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $323.59 | Professional | None | $158.49 | $218.78 | $323.59 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $131.83 Median $263.03 Typical High $501.19 | Professional | None | $131.83 | $263.03 | $501.19 |
Wellmark Setting Professional Modifier None Typical Low $218.78 Median $251.19 Typical High $467.74 | Professional | None | $218.78 | $251.19 | $467.74 |
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 $46.77 Median $77.62 Typical High $85.11 | Professional | 52 · Reduced service | $46.77 | $77.62 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.62 Median $30.90 Typical High $34.67 | Professional | 53 · Discontinued | $18.62 | $30.90 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $114.82 Typical High $128.82 | Professional | 54 · Surgery only | $70.79 | $114.82 | $128.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $22.91 Typical High $25.70 | Professional | 55 · Aftercare only | $14.13 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $15.49 Typical High $16.98 | Professional | 56 · Pre-op care only | $9.33 | $15.49 | $16.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $107.15 Typical High $120.23 | Professional | 78 · Unplanned return to OR | $66.07 | $107.15 | $120.23 |
Where South Dakota sits
The same service costs 3.5 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· 7th of 51
$257
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.