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 $3,801.89 Median $3,801.89 Typical High $4,365.16 | Facility | None | $3,801.89 | $3,801.89 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $3,162.28 Median $3,162.28 Typical High $3,801.89 | Professional | None | $3,162.28 | $3,162.28 | $3,801.89 |
Cigna Setting Facility Modifier None Typical Low $5,370.32 Median $5,370.32 Typical High $6,606.93 | Facility | None | $5,370.32 | $5,370.32 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $6,025.60 Median $8,511.38 Typical High $10,715.19 | Professional | None | $6,025.60 | $8,511.38 | $10,715.19 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $4,466.84 Typical High $5,370.32 | Facility | None | $758.58 | $4,466.84 | $5,370.32 |
Medica Setting Professional Modifier None Typical Low $3,890.45 Median $8,709.64 Typical High $28,840.32 | Professional | None | $3,890.45 | $8,709.64 | $28,840.32 |
Midlands Setting Professional Modifier None Typical Low $8,511.38 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,511.38 | $8,709.64 | $8,709.64 |
Midlands Setting Professional Modifier None Typical Low $7,413.10 Median $7,413.10 Typical High $7,413.10 | Professional | None | $7,413.10 | $7,413.10 | $7,413.10 |
Sanford Health Plan Setting Professional Modifier None Typical Low $3,801.89 Median $5,495.41 Typical High $7,585.78 | Professional | None | $3,801.89 | $5,495.41 | $7,585.78 |
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 $3,715.35 Median $7,079.46 Typical High $10,471.29 | Professional | None | $3,715.35 | $7,079.46 | $10,471.29 |
Wellmark Setting Professional Modifier None Typical Low $7,943.28 Median $9,332.54 Typical High $9,332.54 | Professional | None | $7,943.28 | $9,332.54 | $9,332.54 |
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 $1,584.89 Median $1,584.89 Typical High $1,905.46 | Professional | 52 · Reduced service | $1,584.89 | $1,584.89 | $1,905.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $630.96 Median $630.96 Typical High $758.58 | Professional | 53 · Discontinued | $630.96 | $630.96 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,344.23 Median $2,344.23 Typical High $2,884.03 | Professional | 54 · Surgery only | $2,344.23 | $2,344.23 | $2,884.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $467.74 Median $467.74 Typical High $575.44 | Professional | 55 · Aftercare only | $467.74 | $467.74 | $575.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $316.23 Median $316.23 Typical High $380.19 | Professional | 56 · Pre-op care only | $316.23 | $316.23 | $380.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,187.76 Median $2,187.76 Typical High $2,691.53 | Professional | 78 · Unplanned return to OR | $2,187.76 | $2,187.76 | $2,691.53 |
Where South Dakota sits
The same service costs 21.9 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· 5th of 51
$7,943
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.