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 $1,548.82 Median $1,548.82 Typical High $4,365.16 | Facility | None | $1,548.82 | $1,548.82 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,258.93 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $2,089.30 Median $2,089.30 Typical High $2,630.27 | Facility | None | $2,089.30 | $2,089.30 | $2,630.27 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $3,467.37 Typical High $4,168.69 | Professional | None | $2,398.83 | $3,467.37 | $4,168.69 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,949.84 Typical High $2,570.40 | Facility | None | $758.58 | $1,949.84 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $1,698.24 Median $3,548.13 Typical High $12,302.69 | Professional | None | $1,698.24 | $3,548.13 | $12,302.69 |
Midlands Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Midlands Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,995.26 Median $2,398.83 Typical High $3,019.95 | Professional | None | $1,995.26 | $2,398.83 | $3,019.95 |
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 $1,621.81 Median $3,090.30 Typical High $4,265.80 | Professional | None | $1,621.81 | $3,090.30 | $4,265.80 |
Wellmark Setting Professional Modifier None Typical Low $3,235.94 Median $3,801.89 Typical High $3,801.89 | Professional | None | $3,235.94 | $3,801.89 | $3,801.89 |
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 $630.96 Median $630.96 Typical High $776.25 | Professional | 52 · Reduced service | $630.96 | $630.96 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $251.19 Typical High $309.03 | Professional | 53 · Discontinued | $251.19 | $251.19 | $309.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,148.15 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,148.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $229.09 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $229.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $125.89 Typical High $154.88 | Professional | 56 · Pre-op care only | $125.89 | $125.89 | $154.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $1,071.52 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $1,071.52 |
Where South Dakota sits
The same service costs 5.4 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· 6th of 51
$3,236
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.