How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $181.97 Median $302.00 Typical High $4,365.16 | Facility | None | $181.97 | $302.00 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $218.78 Typical High $380.19 | Professional | None | $125.89 | $218.78 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $371.54 Typical High $588.84 | Facility | None | $218.78 | $371.54 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $346.74 Median $537.03 Typical High $851.14 | Professional | None | $346.74 | $537.03 | $851.14 |
Medica Setting Facility Modifier None Typical Low $234.42 Median $446.68 Typical High $741.31 | Facility | None | $234.42 | $446.68 | $741.31 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $660.69 Typical High $2,290.87 | Professional | None | $223.87 | $660.69 | $2,290.87 |
Midlands Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $660.69 | Professional | None | $407.38 | $407.38 | $660.69 |
Midlands Setting Facility Modifier None Typical Low $218.78 Median $338.84 Typical High $478.63 | Facility | None | $218.78 | $338.84 | $478.63 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $398.11 | Professional | None | $263.03 | $263.03 | $398.11 |
Sanford Health Plan Setting Professional Modifier None Typical Low $229.09 Median $354.81 Typical High $575.44 | Professional | None | $229.09 | $354.81 | $575.44 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $158.49 Median $371.54 Typical High $851.14 | Professional | None | $158.49 | $371.54 | $851.14 |
Wellmark Setting Professional Modifier None Typical Low $426.58 Median $501.19 Typical High $912.01 | Professional | None | $426.58 | $501.19 | $912.01 |
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 $79.43 Median $138.04 Typical High $154.88 | Professional | 52 · Reduced service | $79.43 | $138.04 | $154.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $54.95 Typical High $61.66 | Professional | 53 · Discontinued | $31.62 | $54.95 | $61.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $204.17 Typical High $229.09 | Professional | 54 · Surgery only | $120.23 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $40.74 Typical High $45.71 | Professional | 55 · Aftercare only | $23.99 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $27.54 Typical High $30.90 | Professional | 56 · Pre-op care only | $15.85 | $27.54 | $30.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $190.55 Typical High $213.80 | Professional | 78 · Unplanned return to OR | $112.20 | $190.55 | $213.80 |
Where South Dakota sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 8th of 51
$437
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.