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 $588.84 Median $3,548.13 Typical High $4,365.16 | Facility | None | $588.84 | $3,548.13 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $478.63 Median $501.19 Typical High $660.69 | Professional | None | $478.63 | $501.19 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $2,290.87 Typical High $13,489.63 | Facility | None | $1,862.09 | $2,290.87 | $13,489.63 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,818.38 Typical High $3,630.78 | Professional | None | $2,089.30 | $2,818.38 | $3,630.78 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $1,380.38 Typical High $4,786.30 | Facility | None | $724.44 | $1,380.38 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $1,148.15 Typical High $4,786.30 | Professional | None | $478.63 | $1,148.15 | $4,786.30 |
Midlands Setting Professional Modifier None Typical Low $1,122.02 Median $2,818.38 Typical High $2,818.38 | Professional | None | $1,122.02 | $2,818.38 | $2,818.38 |
Midlands Setting Facility Modifier None Typical Low $13,489.63 Median $13,489.63 Typical High $16,218.10 | Facility | None | $13,489.63 | $13,489.63 | $16,218.10 |
Midlands Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $4,786.30 | Facility | None | $3,981.07 | $3,981.07 | $4,786.30 |
United Setting Professional Modifier None Typical Low $416.87 Median $851.14 Typical High $1,479.11 | Professional | None | $416.87 | $851.14 | $1,479.11 |
Wellmark Setting Professional Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $4,168.69 | Professional | None | $3,548.13 | $4,168.69 | $4,168.69 |
2 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 54 · Surgery only Typical Low $363.08 Median $380.19 Typical High $436.52 | Professional | 54 · Surgery only | $363.08 | $380.19 | $436.52 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $338.84 Median $354.81 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $338.84 | $354.81 | $407.38 |
Where South Dakota sits
The same service costs 8.3 times more in South Dakota than in Kentucky. 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· 1st 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.