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 $741.31 Median $4,365.16 Typical High $4,897.79 | Facility | None | $741.31 | $4,365.16 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $741.31 | Professional | None | $630.96 | $630.96 | $741.31 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,318.26 Typical High $4,073.80 | Facility | None | $1,071.52 | $1,318.26 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,698.24 Typical High $2,137.96 | Professional | None | $1,202.26 | $1,698.24 | $2,137.96 |
Medica Setting Facility Modifier None Typical Low $977.24 Median $1,737.80 Typical High $3,890.45 | Facility | None | $977.24 | $1,737.80 | $3,890.45 |
Medica Setting Professional Modifier None Typical Low $812.83 Median $1,698.24 Typical High $8,317.64 | Professional | None | $812.83 | $1,698.24 | $8,317.64 |
Midlands Setting Professional Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $1,737.80 | Professional | None | $1,698.24 | $1,698.24 | $1,737.80 |
Midlands Setting Facility Modifier None Typical Low $4,073.80 Median $4,073.80 Typical High $4,897.79 | Facility | None | $4,073.80 | $4,073.80 | $4,897.79 |
Midlands Setting Professional Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,584.89 | $1,584.89 | $1,584.89 |
Sanford Health Plan Setting Professional Modifier None Typical Low $912.01 Median $1,096.48 Typical High $1,513.56 | Professional | None | $912.01 | $1,096.48 | $1,513.56 |
United Setting Facility Modifier None Typical Low $3,235.94 Median $3,235.94 Typical High $3,890.45 | Facility | None | $3,235.94 | $3,235.94 | $3,890.45 |
United Setting Professional Modifier None Typical Low $724.44 Median $1,479.11 Typical High $2,041.74 | Professional | None | $724.44 | $1,479.11 | $2,041.74 |
Wellmark Setting Professional Modifier None Typical Low $1,621.81 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,621.81 | $1,862.09 | $1,862.09 |
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 $316.23 Median $316.23 Typical High $371.54 | Professional | 52 · Reduced service | $316.23 | $316.23 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $125.89 Typical High $151.36 | Professional | 53 · Discontinued | $125.89 | $125.89 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $467.74 Typical High $562.34 | Professional | 54 · Surgery only | $467.74 | $467.74 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $93.33 Typical High $112.20 | Professional | 55 · Aftercare only | $93.33 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $63.10 Median $63.10 Typical High $74.13 | Professional | 56 · Pre-op care only | $63.10 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $436.52 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $436.52 | $436.52 | $524.81 |
Where South Dakota sits
The same service costs 25.1 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· 6th of 51
$1,698
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.