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 $3,548.13 Median $5,754.40 Typical High $5,754.40 | Facility | None | $3,548.13 | $5,754.40 | $5,754.40 |
Aetna Setting Professional Modifier None Typical Low $251.19 Median $281.84 Typical High $416.87 | Professional | None | $251.19 | $281.84 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $1,479.11 Typical High $3,801.89 | Facility | None | $426.58 | $1,479.11 | $3,801.89 |
Cigna Setting Professional Modifier None Typical Low $489.78 Median $660.69 Typical High $851.14 | Professional | None | $489.78 | $660.69 | $851.14 |
Medica Setting Facility Modifier None Typical Low $389.05 Median $1,513.56 Typical High $3,467.37 | Facility | None | $389.05 | $1,513.56 | $3,467.37 |
Medica Setting Professional Modifier None Typical Low $316.23 Median $660.69 Typical High $2,630.27 | Professional | None | $316.23 | $660.69 | $2,630.27 |
Midlands Setting Professional Modifier None Typical Low $645.65 Median $660.69 Typical High $660.69 | Professional | None | $645.65 | $660.69 | $660.69 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $4,073.80 | Facility | None | $1,096.48 | $1,659.59 | $4,073.80 |
Midlands Setting Professional Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Professional | None | $602.56 | $602.56 | $602.56 |
Sanford Health Plan Setting Professional Modifier None Typical Low $346.74 Median $416.87 Typical High $575.44 | Professional | None | $346.74 | $416.87 | $575.44 |
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 $281.84 Median $575.44 Typical High $794.33 | Professional | None | $281.84 | $575.44 | $794.33 |
Wellmark Setting Professional Modifier None Typical Low $575.44 Median $660.69 Typical High $660.69 | Professional | None | $575.44 | $660.69 | $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 $125.89 Median $125.89 Typical High $144.54 | Professional | 52 · Reduced service | $125.89 | $125.89 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $50.12 Typical High $57.54 | Professional | 53 · Discontinued | $50.12 | $50.12 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $186.21 Median $186.21 Typical High $213.80 | Professional | 54 · Surgery only | $186.21 | $186.21 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $38.02 Median $38.02 Typical High $42.66 | Professional | 55 · Aftercare only | $38.02 | $38.02 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $25.12 Median $25.12 Typical High $28.84 | Professional | 56 · Pre-op care only | $25.12 | $25.12 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $173.78 | $173.78 | $199.53 |
Where South Dakota sits
The same service costs 5.5 times more in Alaska than in Utah. 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
$661
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.