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 $263.03 Median $2,290.87 Typical High $4,365.16 | Facility | None | $263.03 | $2,290.87 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $229.09 Median $229.09 Typical High $263.03 | Professional | None | $229.09 | $229.09 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $1,174.90 Typical High $1,862.09 | Facility | None | $398.11 | $1,174.90 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $446.68 Median $588.84 Typical High $794.33 | Professional | None | $446.68 | $588.84 | $794.33 |
Medica Setting Facility Modifier None Typical Low $281.84 Median $588.84 Typical High $1,202.26 | Facility | None | $281.84 | $588.84 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $239.88 Median $588.84 Typical High $1,995.26 | Professional | None | $239.88 | $588.84 | $1,995.26 |
Midlands Setting Professional Modifier None Typical Low $549.54 Median $588.84 Typical High $588.84 | Professional | None | $549.54 | $588.84 | $588.84 |
Midlands Setting Facility Modifier None Typical Low $1,174.90 Median $1,698.24 Typical High $2,290.87 | Facility | None | $1,174.90 | $1,698.24 | $2,290.87 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $467.74 | Professional | None | $467.74 | $467.74 | $467.74 |
Sanford Health Plan Setting Professional Modifier None Typical Low $245.47 Median $371.54 Typical High $537.03 | Professional | None | $245.47 | $371.54 | $537.03 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $239.88 Median $457.09 Typical High $724.44 | Professional | None | $239.88 | $457.09 | $724.44 |
Wellmark Setting Professional Modifier None Typical Low $645.65 Median $741.31 Typical High $741.31 | Professional | None | $645.65 | $741.31 | $741.31 |
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 $114.82 Median $114.82 Typical High $131.83 | Professional | 52 · Reduced service | $114.82 | $114.82 | $131.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $45.71 Median $45.71 Typical High $52.48 | Professional | 53 · Discontinued | $45.71 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $173.78 Typical High $199.53 | Professional | 54 · Surgery only | $173.78 | $173.78 | $199.53 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $34.67 Typical High $39.81 | Professional | 55 · Aftercare only | $34.67 | $34.67 | $39.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $22.91 Typical High $26.30 | Professional | 56 · Pre-op care only | $22.91 | $22.91 | $26.30 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $162.18 Median $162.18 Typical High $186.21 | Professional | 78 · Unplanned return to OR | $162.18 | $162.18 | $186.21 |
Where South Dakota sits
The same service costs 5.2 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
$589
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.