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 $1,258.93 Median $1,258.93 Typical High $4,365.16 | Facility | None | $1,258.93 | $1,258.93 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | None | $1,047.13 | $1,047.13 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $2,187.76 | Facility | None | $1,778.28 | $1,778.28 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,995.26 Median $2,818.38 Typical High $3,548.13 | Professional | None | $1,995.26 | $2,818.38 | $3,548.13 |
Medica Setting Facility Modifier None Typical Low $1,513.56 Median $2,818.38 Typical High $3,311.31 | Facility | None | $1,513.56 | $2,818.38 | $3,311.31 |
Medica Setting Professional Modifier None Typical Low $1,288.25 Median $2,818.38 Typical High $11,748.98 | Professional | None | $1,288.25 | $2,818.38 | $11,748.98 |
Midlands Setting Professional Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $2,884.03 | Professional | None | $2,818.38 | $2,818.38 | $2,884.03 |
Midlands Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,513.56 Median $1,819.70 Typical High $2,511.89 | Professional | None | $1,513.56 | $1,819.70 | $2,511.89 |
United Setting Facility Modifier None Typical Low $2,818.38 Median $2,818.38 Typical High $3,311.31 | Facility | None | $2,818.38 | $2,818.38 | $3,311.31 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $2,454.71 Typical High $3,467.37 | Professional | None | $1,202.26 | $2,454.71 | $3,467.37 |
Wellmark Setting Professional Modifier None Typical Low $2,691.53 Median $3,090.30 Typical High $3,090.30 | Professional | None | $2,691.53 | $3,090.30 | $3,090.30 |
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 $524.81 Median $524.81 Typical High $630.96 | Professional | 52 · Reduced service | $524.81 | $524.81 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | 53 · Discontinued | $208.93 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $776.25 Median $776.25 Typical High $933.25 | Professional | 54 · Surgery only | $776.25 | $776.25 | $933.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $186.21 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $104.71 Median $104.71 Typical High $125.89 | Professional | 56 · Pre-op care only | $104.71 | $104.71 | $125.89 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $724.44 Median $724.44 Typical High $870.96 | Professional | 78 · Unplanned return to OR | $724.44 | $724.44 | $870.96 |
Where South Dakota sits
The same service costs 26.3 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
$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.