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 $173.78 Median $257.04 Typical High $4,365.16 | Facility | None | $173.78 | $257.04 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $154.88 Median $229.09 Typical High $251.19 | Professional | None | $154.88 | $229.09 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $213.80 Median $380.19 Typical High $478.63 | Facility | None | $213.80 | $380.19 | $478.63 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $489.78 Typical High $660.69 | Professional | None | $346.74 | $489.78 | $660.69 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $263.03 Typical High $426.58 | Facility | None | $125.89 | $263.03 | $426.58 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $575.44 Typical High $2,398.83 | Professional | None | $281.84 | $575.44 | $2,398.83 |
Midlands Setting Professional Modifier None Typical Low $407.38 Median $457.09 Typical High $575.44 | Professional | None | $407.38 | $457.09 | $575.44 |
Midlands Setting Facility Modifier None Typical Low $213.80 Median $380.19 Typical High $645.65 | Facility | None | $213.80 | $380.19 | $645.65 |
Midlands Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $524.81 | Professional | None | $363.08 | $363.08 | $524.81 |
Sanford Health Plan Setting Professional Modifier None Typical Low $245.47 Median $346.74 Typical High $478.63 | Professional | None | $245.47 | $346.74 | $478.63 |
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 $208.93 Median $398.11 Typical High $724.44 | Professional | None | $208.93 | $398.11 | $724.44 |
Wellmark Setting Professional Modifier None Typical Low $354.81 Median $416.87 Typical High $660.69 | Professional | None | $354.81 | $416.87 | $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 $77.62 Median $114.82 Typical High $125.89 | Professional | 52 · Reduced service | $77.62 | $114.82 | $125.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.90 Median $45.71 Typical High $50.12 | Professional | 53 · Discontinued | $30.90 | $45.71 | $50.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $114.82 Median $169.82 Typical High $186.21 | Professional | 54 · Surgery only | $114.82 | $169.82 | $186.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.91 Median $33.88 Typical High $38.02 | Professional | 55 · Aftercare only | $22.91 | $33.88 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.49 Median $22.91 Typical High $25.12 | Professional | 56 · Pre-op care only | $15.49 | $22.91 | $25.12 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $107.15 Median $158.49 Typical High $173.78 | Professional | 78 · Unplanned return to OR | $107.15 | $158.49 | $173.78 |
Where South Dakota sits
The same service costs 4.2 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· 6th of 51
$417
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.