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 $1,659.59 Median $1,659.59 Typical High $4,365.16 | Facility | None | $1,659.59 | $1,659.59 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,659.59 | Professional | None | $1,380.38 | $1,380.38 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,951.21 | Facility | None | $2,344.23 | $2,344.23 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $2,630.27 Median $3,801.89 Typical High $4,677.35 | Professional | None | $2,630.27 | $3,801.89 | $4,677.35 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,995.26 Typical High $2,344.23 | Facility | None | $758.58 | $1,995.26 | $2,344.23 |
Medica Setting Professional Modifier None Typical Low $1,778.28 Median $3,801.89 Typical High $12,302.69 | Professional | None | $1,778.28 | $3,801.89 | $12,302.69 |
Midlands Setting Professional Modifier None Typical Low $3,801.89 Median $3,801.89 Typical High $3,890.45 | Professional | None | $3,801.89 | $3,801.89 | $3,890.45 |
Midlands Setting Professional Modifier None Typical Low $3,548.13 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,548.13 | $3,548.13 | $3,548.13 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,949.84 Median $2,454.71 Typical High $3,311.31 | Professional | None | $1,949.84 | $2,454.71 | $3,311.31 |
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 $1,621.81 Median $3,235.94 Typical High $4,570.88 | Professional | None | $1,621.81 | $3,235.94 | $4,570.88 |
Wellmark Setting Professional Modifier None Typical Low $3,548.13 Median $4,073.80 Typical High $4,073.80 | Professional | None | $3,548.13 | $4,073.80 | $4,073.80 |
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 $691.83 Median $691.83 Typical High $831.76 | Professional | 52 · Reduced service | $691.83 | $691.83 | $831.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $275.42 Typical High $331.13 | Professional | 53 · Discontinued | $275.42 | $275.42 | $331.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,258.93 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,258.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $251.19 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $138.04 Typical High $165.96 | Professional | 56 · Pre-op care only | $138.04 | $138.04 | $165.96 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,174.90 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,174.90 |
Where South Dakota sits
The same service costs 5.4 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
$3,548
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.