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 $2,398.83 Median $2,398.83 Typical High $4,365.16 | Facility | None | $2,398.83 | $2,398.83 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $3,235.94 | Professional | None | $1,995.26 | $1,995.26 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $4,168.69 | Facility | None | $3,388.44 | $3,388.44 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $3,801.89 Median $5,370.32 Typical High $6,760.83 | Professional | None | $3,801.89 | $5,370.32 | $6,760.83 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $2,818.38 Typical High $3,388.44 | Facility | None | $758.58 | $2,818.38 | $3,388.44 |
Medica Setting Professional Modifier None Typical Low $2,454.71 Median $5,495.41 Typical High $17,782.79 | Professional | None | $2,454.71 | $5,495.41 | $17,782.79 |
Midlands Setting Professional Modifier None Typical Low $5,495.41 Median $5,495.41 Typical High $5,495.41 | Professional | None | $5,495.41 | $5,495.41 | $5,495.41 |
Midlands Setting Professional Modifier None Typical Low $5,128.61 Median $5,128.61 Typical High $5,128.61 | Professional | None | $5,128.61 | $5,128.61 | $5,128.61 |
Sanford Health Plan Setting Professional Modifier None Typical Low $2,691.53 Median $3,548.13 Typical High $4,786.30 | Professional | None | $2,691.53 | $3,548.13 | $4,786.30 |
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 $2,344.23 Median $4,677.35 Typical High $6,606.93 | Professional | None | $2,344.23 | $4,677.35 | $6,606.93 |
Wellmark Setting Professional Modifier None Typical Low $5,011.87 Median $5,888.44 Typical High $5,888.44 | Professional | None | $5,011.87 | $5,888.44 | $5,888.44 |
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 $1,000.00 Median $1,000.00 Typical High $1,202.26 | Professional | 52 · Reduced service | $1,000.00 | $1,000.00 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $398.11 Median $398.11 Typical High $478.63 | Professional | 53 · Discontinued | $398.11 | $398.11 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,479.11 Median $1,479.11 Typical High $1,819.70 | Professional | 54 · Surgery only | $1,479.11 | $1,479.11 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $295.12 Median $295.12 Typical High $363.08 | Professional | 55 · Aftercare only | $295.12 | $295.12 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $199.53 Median $199.53 Typical High $239.88 | Professional | 56 · Pre-op care only | $199.53 | $199.53 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,380.38 Median $1,380.38 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $1,380.38 | $1,380.38 | $1,698.24 |
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· 5th of 51
$5,012
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.