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 $831.76 Median $831.76 Typical High $4,365.16 | Facility | None | $831.76 | $831.76 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $831.76 | Professional | None | $691.83 | $691.83 | $831.76 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $3,019.95 Typical High $3,801.89 | Facility | None | $1,174.90 | $3,019.95 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $1,905.46 Typical High $2,344.23 | Professional | None | $1,348.96 | $1,905.46 | $2,344.23 |
Medica Setting Facility Modifier None Typical Low $1,096.48 Median $1,905.46 Typical High $3,311.31 | Facility | None | $1,096.48 | $1,905.46 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $912.01 Median $1,905.46 Typical High $7,079.46 | Professional | None | $912.01 | $1,905.46 | $7,079.46 |
Midlands Setting Professional Modifier None Typical Low $1,778.28 Median $1,905.46 Typical High $1,905.46 | Professional | None | $1,778.28 | $1,905.46 | $1,905.46 |
Midlands Setting Facility Modifier None Typical Low $1,288.25 Median $3,019.95 Typical High $4,073.80 | Facility | None | $1,288.25 | $3,019.95 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,698.24 | Professional | None | $1,698.24 | $1,698.24 | $1,698.24 |
Sanford Health Plan Setting Professional Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,584.89 | Professional | None | $977.24 | $1,174.90 | $1,584.89 |
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 $831.76 Median $1,659.59 Typical High $2,290.87 | Professional | None | $831.76 | $1,659.59 | $2,290.87 |
Wellmark Setting Professional Modifier None Typical Low $1,584.89 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,584.89 | $1,819.70 | $1,819.70 |
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 $346.74 Median $346.74 Typical High $416.87 | Professional | 52 · Reduced service | $346.74 | $346.74 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 53 · Discontinued | $141.25 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $524.81 Median $524.81 Typical High $616.60 | Professional | 54 · Surgery only | $524.81 | $524.81 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $104.71 Median $104.71 Typical High $123.03 | Professional | 55 · Aftercare only | $104.71 | $104.71 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $69.18 | $69.18 | $83.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $489.78 Median $489.78 Typical High $575.44 | Professional | 78 · Unplanned return to OR | $489.78 | $489.78 | $575.44 |
Where South Dakota sits
The same service costs 6.5 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
$1,820
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.