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 $363.08 Median $3,090.30 Typical High $4,365.16 | Facility | None | $363.08 | $3,090.30 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $363.08 | Professional | None | $309.03 | $309.03 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $537.03 Median $1,698.24 Typical High $1,949.84 | Facility | None | $537.03 | $1,698.24 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $831.76 Typical High $1,071.52 | Professional | None | $602.56 | $831.76 | $1,071.52 |
Medica Setting Facility Modifier None Typical Low $426.58 Median $851.14 Typical High $1,819.70 | Facility | None | $426.58 | $851.14 | $1,819.70 |
Medica Setting Professional Modifier None Typical Low $363.08 Median $831.76 Typical High $3,981.07 | Professional | None | $363.08 | $831.76 | $3,981.07 |
Midlands Setting Professional Modifier None Typical Low $831.76 Median $831.76 Typical High $851.14 | Professional | None | $831.76 | $831.76 | $851.14 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,698.24 Typical High $2,137.96 | Facility | None | $954.99 | $1,698.24 | $2,137.96 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $758.58 | Professional | None | $758.58 | $758.58 | $758.58 |
Sanford Health Plan Setting Professional Modifier None Typical Low $416.87 Median $537.03 Typical High $741.31 | Professional | None | $416.87 | $537.03 | $741.31 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,513.56 | $1,513.56 | $1,819.70 |
United Setting Professional Modifier None Typical Low $354.81 Median $707.95 Typical High $1,000.00 | Professional | None | $354.81 | $707.95 | $1,000.00 |
Wellmark Setting Professional Modifier None Typical Low $831.76 Median $954.99 Typical High $954.99 | Professional | None | $831.76 | $954.99 | $954.99 |
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 $154.88 Median $154.88 Typical High $181.97 | Professional | 52 · Reduced service | $154.88 | $154.88 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $63.10 Median $63.10 Typical High $72.44 | Professional | 53 · Discontinued | $63.10 | $63.10 | $72.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $234.42 Median $234.42 Typical High $275.42 | Professional | 54 · Surgery only | $234.42 | $234.42 | $275.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $46.77 Median $46.77 Typical High $54.95 | Professional | 55 · Aftercare only | $46.77 | $46.77 | $54.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.90 Median $30.90 Typical High $36.31 | Professional | 56 · Pre-op care only | $30.90 | $30.90 | $36.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $218.78 Median $218.78 Typical High $257.04 | Professional | 78 · Unplanned return to OR | $218.78 | $218.78 | $257.04 |
Where South Dakota sits
The same service costs 5.1 times more in Alaska than in Utah. 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
$832
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.