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 $1,288.25 Median $1,288.25 Typical High $4,365.16 | Facility | None | $1,288.25 | $1,288.25 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,288.25 | Professional | None | $1,071.52 | $1,071.52 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,238.72 | Facility | None | $1,778.28 | $1,778.28 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $2,041.74 Median $2,884.03 Typical High $3,548.13 | Professional | None | $2,041.74 | $2,884.03 | $3,548.13 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,548.82 Typical High $1,995.26 | Facility | None | $758.58 | $1,548.82 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $2,951.21 Typical High $9,549.93 | Professional | None | $1,348.96 | $2,951.21 | $9,549.93 |
Midlands Setting Professional Modifier None Typical Low $2,951.21 Median $2,951.21 Typical High $2,951.21 | Professional | None | $2,951.21 | $2,951.21 | $2,951.21 |
Midlands Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,754.23 | Professional | None | $2,754.23 | $2,754.23 | $2,754.23 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,318.26 Median $1,905.46 Typical High $2,570.40 | Professional | None | $1,318.26 | $1,905.46 | $2,570.40 |
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 $1,288.25 Median $2,630.27 Typical High $3,548.13 | Professional | None | $1,288.25 | $2,630.27 | $3,548.13 |
Wellmark Setting Professional Modifier None Typical Low $2,818.38 Median $3,235.94 Typical High $3,235.94 | Professional | None | $2,818.38 | $3,235.94 | $3,235.94 |
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 $537.03 Median $537.03 Typical High $645.65 | Professional | 52 · Reduced service | $537.03 | $537.03 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $213.80 Typical High $257.04 | Professional | 53 · Discontinued | $213.80 | $213.80 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $794.33 Median $794.33 Typical High $954.99 | Professional | 54 · Surgery only | $794.33 | $794.33 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $158.49 Median $158.49 Typical High $190.55 | Professional | 55 · Aftercare only | $158.49 | $158.49 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $107.15 Typical High $128.82 | Professional | 56 · Pre-op care only | $107.15 | $107.15 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $741.31 Median $741.31 Typical High $891.25 | Professional | 78 · Unplanned return to OR | $741.31 | $741.31 | $891.25 |
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· 6th of 51
$2,818
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.