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 $2,754.23 Median $2,754.23 Typical High $4,365.16 | Facility | None | $2,754.23 | $2,754.23 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,754.23 | Professional | None | $2,290.87 | $2,290.87 | $2,754.23 |
Cigna Setting Facility Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $4,786.30 | Facility | None | $3,801.89 | $3,801.89 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $4,365.16 Median $6,165.95 Typical High $7,585.78 | Professional | None | $4,365.16 | $6,165.95 | $7,585.78 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $3,019.95 Typical High $3,801.89 | Facility | None | $758.58 | $3,019.95 | $3,801.89 |
Medica Setting Professional Modifier None Typical Low $2,691.53 Median $6,309.57 Typical High $20,417.38 | Professional | None | $2,691.53 | $6,309.57 | $20,417.38 |
Midlands Setting Professional Modifier None Typical Low $6,309.57 Median $6,309.57 Typical High $6,309.57 | Professional | None | $6,309.57 | $6,309.57 | $6,309.57 |
Midlands Setting Professional Modifier None Typical Low $6,025.60 Median $6,025.60 Typical High $6,025.60 | Professional | None | $6,025.60 | $6,025.60 | $6,025.60 |
Sanford Health Plan Setting Professional Modifier None Typical Low $2,951.21 Median $4,073.80 Typical High $5,495.41 | Professional | None | $2,951.21 | $4,073.80 | $5,495.41 |
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 $2,570.40 Median $5,495.41 Typical High $7,585.78 | Professional | None | $2,570.40 | $5,495.41 | $7,585.78 |
Wellmark Setting Professional Modifier None Typical Low $5,888.44 Median $6,918.31 Typical High $6,918.31 | Professional | None | $5,888.44 | $6,918.31 | $6,918.31 |
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 $1,122.02 Median $1,122.02 Typical High $1,380.38 | Professional | 52 · Reduced service | $1,122.02 | $1,122.02 | $1,380.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $457.09 Typical High $549.54 | Professional | 53 · Discontinued | $457.09 | $457.09 | $549.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $1,698.24 Typical High $2,089.30 | Professional | 54 · Surgery only | $1,698.24 | $1,698.24 | $2,089.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $338.84 Typical High $416.87 | Professional | 55 · Aftercare only | $338.84 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $229.09 Median $229.09 Typical High $275.42 | Professional | 56 · Pre-op care only | $229.09 | $229.09 | $275.42 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $1,584.89 Typical High $1,949.84 | Professional | 78 · Unplanned return to OR | $1,584.89 | $1,584.89 | $1,949.84 |
Where South Dakota sits
The same service costs 5.1 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
$5,888
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.