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 $407.38 Median $2,290.87 Typical High $4,365.16 | Facility | None | $407.38 | $2,290.87 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $407.38 | Professional | None | $354.81 | $354.81 | $407.38 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $162.18 Typical High $758.58 | Facility | None | $72.44 | $162.18 | $758.58 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $933.25 Typical High $1,202.26 | Professional | None | $676.08 | $933.25 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $512.86 Typical High $812.83 | Facility | None | $125.89 | $512.86 | $812.83 |
Medica Setting Professional Modifier None Typical Low $446.68 Median $933.25 Typical High $3,090.30 | Professional | None | $446.68 | $933.25 | $3,090.30 |
Midlands Setting Professional Modifier None Typical Low $912.01 Median $933.25 Typical High $933.25 | Professional | None | $912.01 | $933.25 | $933.25 |
Midlands Setting Facility Modifier None Typical Low $72.44 Median $158.49 Typical High $208.93 | Facility | None | $72.44 | $158.49 | $208.93 |
Midlands Setting Professional Modifier None Typical Low $851.14 Median $851.14 Typical High $851.14 | Professional | None | $851.14 | $851.14 | $851.14 |
Sanford Health Plan Setting Professional Modifier None Typical Low $407.38 Median $588.84 Typical High $812.83 | Professional | None | $407.38 | $588.84 | $812.83 |
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 $389.05 Median $812.83 Typical High $1,122.02 | Professional | None | $389.05 | $812.83 | $1,122.02 |
Wellmark Setting Professional Modifier None Typical Low $812.83 Median $933.25 Typical High $933.25 | Professional | None | $812.83 | $933.25 | $933.25 |
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 $177.83 Median $177.83 Typical High $204.17 | Professional | 52 · Reduced service | $177.83 | $177.83 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $70.79 Typical High $81.28 | Professional | 53 · Discontinued | $70.79 | $70.79 | $81.28 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $263.03 Median $263.03 Typical High $309.03 | Professional | 54 · Surgery only | $263.03 | $263.03 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $52.48 Typical High $61.66 | Professional | 55 · Aftercare only | $52.48 | $52.48 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $35.48 Typical High $40.74 | Professional | 56 · Pre-op care only | $35.48 | $35.48 | $40.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $245.47 Typical High $288.40 | Professional | 78 · Unplanned return to OR | $245.47 | $245.47 | $288.40 |
Where South Dakota sits
The same service costs 4.2 times more in Wyoming 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· 6th of 51
$832
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.