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 $2,238.72 Median $2,238.72 Typical High $4,365.16 | Facility | None | $2,238.72 | $2,238.72 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $2,238.72 | Professional | None | $1,862.09 | $1,862.09 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,981.07 | Facility | None | $3,162.28 | $3,162.28 | $3,981.07 |
Cigna Setting Professional Modifier None Typical Low $3,548.13 Median $5,128.61 Typical High $6,309.57 | Professional | None | $3,548.13 | $5,128.61 | $6,309.57 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $2,630.27 Typical High $3,162.28 | Facility | None | $758.58 | $2,630.27 | $3,162.28 |
Medica Setting Professional Modifier None Typical Low $2,187.76 Median $5,128.61 Typical High $16,595.87 | Professional | None | $2,187.76 | $5,128.61 | $16,595.87 |
Midlands Setting Professional Modifier None Typical Low $4,897.79 Median $5,128.61 Typical High $5,128.61 | Professional | None | $4,897.79 | $5,128.61 | $5,128.61 |
Midlands Setting Professional Modifier None Typical Low $4,265.80 Median $4,265.80 Typical High $4,265.80 | Professional | None | $4,265.80 | $4,265.80 | $4,265.80 |
Sanford Health Plan Setting Professional Modifier None Typical Low $2,290.87 Median $3,235.94 Typical High $4,466.84 | Professional | None | $2,290.87 | $3,235.94 | $4,466.84 |
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 $2,137.96 Median $4,168.69 Typical High $6,165.95 | Professional | None | $2,137.96 | $4,168.69 | $6,165.95 |
Wellmark Setting Professional Modifier None Typical Low $4,786.30 Median $5,495.41 Typical High $5,495.41 | Professional | None | $4,786.30 | $5,495.41 | $5,495.41 |
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 $933.25 Median $933.25 Typical High $1,122.02 | Professional | 52 · Reduced service | $933.25 | $933.25 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $371.54 Median $371.54 Typical High $446.68 | Professional | 53 · Discontinued | $371.54 | $371.54 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,412.54 Median $1,412.54 Typical High $1,659.59 | Professional | 54 · Surgery only | $1,412.54 | $1,412.54 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $281.84 Median $281.84 Typical High $331.13 | Professional | 55 · Aftercare only | $281.84 | $281.84 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | 56 · Pre-op care only | $186.21 | $186.21 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,318.26 Median $1,318.26 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $1,318.26 | $1,318.26 | $1,548.82 |
Where South Dakota sits
The same service costs 20.9 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· 4th of 51
$4,786
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.