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 $1,288.25 Median $1,288.25 Typical High $4,365.16 | Facility | None | $1,288.25 | $1,288.25 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $1,096.48 Median $1,096.48 Typical High $1,288.25 | Professional | None | $1,096.48 | $1,096.48 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,290.87 | Facility | None | $1,862.09 | $1,862.09 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $2,089.30 Median $2,951.21 Typical High $3,715.35 | Professional | None | $2,089.30 | $2,951.21 | $3,715.35 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,548.82 Typical High $2,187.76 | Facility | None | $758.58 | $1,548.82 | $2,187.76 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $3,019.95 Typical High $11,481.54 | Professional | None | $1,348.96 | $3,019.95 | $11,481.54 |
Midlands Setting Professional Modifier None Typical Low $2,884.03 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,884.03 | $3,019.95 | $3,019.95 |
Midlands Setting Professional Modifier None Typical Low $2,691.53 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,691.53 | $2,691.53 | $2,691.53 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,513.56 Median $1,905.46 Typical High $2,511.89 | Professional | None | $1,513.56 | $1,905.46 | $2,511.89 |
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 $1,202.26 Median $2,570.40 Typical High $3,630.78 | Professional | None | $1,202.26 | $2,570.40 | $3,630.78 |
Wellmark Setting Professional Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,630.27 | $3,019.95 | $3,019.95 |
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 $549.54 Median $549.54 Typical High $645.65 | Professional | 52 · Reduced service | $549.54 | $549.54 | $645.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $218.78 Median $218.78 Typical High $257.04 | Professional | 53 · Discontinued | $218.78 | $218.78 | $257.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $812.83 Typical High $977.24 | Professional | 54 · Surgery only | $812.83 | $812.83 | $977.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $162.18 Typical High $194.98 | Professional | 55 · Aftercare only | $162.18 | $162.18 | $194.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $109.65 Median $109.65 Typical High $128.82 | Professional | 56 · Pre-op care only | $109.65 | $109.65 | $128.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $758.58 Typical High $912.01 | Professional | 78 · Unplanned return to OR | $758.58 | $758.58 | $912.01 |
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
$2,630
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.