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 $3,548.13 Median $3,548.13 Typical High $4,365.16 | Facility | None | $3,548.13 | $3,548.13 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,884.03 | $2,884.03 | $3,548.13 |
Cigna Setting Facility Modifier None Typical Low $4,786.30 Median $4,786.30 Typical High $6,025.60 | Facility | None | $4,786.30 | $4,786.30 | $6,025.60 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $9,549.93 | Professional | None | $5,495.41 | $7,762.47 | $9,549.93 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $3,801.89 Typical High $4,786.30 | Facility | None | $758.58 | $3,801.89 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $3,388.44 Median $8,128.31 Typical High $25,703.96 | Professional | None | $3,388.44 | $8,128.31 | $25,703.96 |
Midlands Setting Professional Modifier None Typical Low $7,943.28 Median $8,128.31 Typical High $8,128.31 | Professional | None | $7,943.28 | $8,128.31 | $8,128.31 |
Midlands Setting Professional Modifier None Typical Low $7,585.78 Median $7,585.78 Typical High $7,585.78 | Professional | None | $7,585.78 | $7,585.78 | $7,585.78 |
Sanford Health Plan Setting Professional Modifier None Typical Low $3,467.37 Median $5,128.61 Typical High $6,918.31 | Professional | None | $3,467.37 | $5,128.61 | $6,918.31 |
United Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $1,202.26 | Facility | None | $758.58 | $758.58 | $1,202.26 |
United Setting Professional Modifier None Typical Low $3,235.94 Median $7,079.46 Typical High $9,772.37 | Professional | None | $3,235.94 | $7,079.46 | $9,772.37 |
Wellmark Setting Professional Modifier None Typical Low $7,413.10 Median $8,511.38 Typical High $8,511.38 | Professional | None | $7,413.10 | $8,511.38 | $8,511.38 |
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 $1,412.54 Median $1,412.54 Typical High $1,778.28 | Professional | 52 · Reduced service | $1,412.54 | $1,412.54 | $1,778.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $707.95 | Professional | 53 · Discontinued | $575.44 | $575.44 | $707.95 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,137.96 Median $2,137.96 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,137.96 | $2,137.96 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $426.58 Median $426.58 Typical High $524.81 | Professional | 55 · Aftercare only | $426.58 | $426.58 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $354.81 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $354.81 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,995.26 Median $1,995.26 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $1,995.26 | $1,995.26 | $2,454.71 |
Where South Dakota sits
The same service costs 21.9 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· 4th of 51
$7,413
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.