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 $2,630.27 Median $2,630.27 Typical High $4,365.16 | Facility | None | $2,630.27 | $2,630.27 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,630.27 | Professional | None | $2,344.23 | $2,344.23 | $2,630.27 |
Cigna Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $5,011.87 | Facility | None | $3,981.07 | $3,981.07 | $5,011.87 |
Cigna Setting Professional Modifier None Typical Low $4,466.84 Median $6,165.95 Typical High $7,943.28 | Professional | None | $4,466.84 | $6,165.95 | $7,943.28 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $3,388.44 Typical High $3,981.07 | Facility | None | $758.58 | $3,388.44 | $3,981.07 |
Medica Setting Professional Modifier None Typical Low $2,951.21 Median $6,165.95 Typical High $20,892.96 | Professional | None | $2,951.21 | $6,165.95 | $20,892.96 |
Midlands Setting Professional Modifier None Typical Low $6,165.95 Median $6,165.95 Typical High $6,456.54 | Professional | None | $6,165.95 | $6,165.95 | $6,456.54 |
Midlands Setting Professional Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $5,754.40 | Professional | None | $5,754.40 | $5,754.40 | $5,754.40 |
Sanford Health Plan Setting Professional Modifier None Typical Low $3,235.94 Median $4,073.80 Typical High $5,623.41 | Professional | None | $3,235.94 | $4,073.80 | $5,623.41 |
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 $2,691.53 Median $5,370.32 Typical High $7,244.36 | Professional | None | $2,691.53 | $5,370.32 | $7,244.36 |
Wellmark Setting Professional Modifier None Typical Low $6,025.60 Median $6,918.31 Typical High $6,918.31 | Professional | None | $6,025.60 | $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 $1,174.90 Median $1,174.90 Typical High $1,318.26 | Professional | 52 · Reduced service | $1,174.90 | $1,174.90 | $1,318.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $467.74 Median $467.74 Typical High $524.81 | Professional | 53 · Discontinued | $467.74 | $467.74 | $524.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,778.28 Median $1,778.28 Typical High $1,995.26 | Professional | 54 · Surgery only | $1,778.28 | $1,778.28 | $1,995.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $354.81 Median $354.81 Typical High $398.11 | Professional | 55 · Aftercare only | $354.81 | $354.81 | $398.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $234.42 Median $234.42 Typical High $263.03 | Professional | 56 · Pre-op care only | $234.42 | $234.42 | $263.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,659.59 Median $1,659.59 Typical High $1,862.09 | Professional | 78 · Unplanned return to OR | $1,659.59 | $1,659.59 | $1,862.09 |
Where South Dakota sits
The same service costs 21.4 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· 4th of 51
$6,026
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.