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 $4,168.69 Median $4,168.69 Typical High $4,365.16 | Facility | None | $4,168.69 | $4,168.69 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $3,388.44 Median $3,388.44 Typical High $4,168.69 | Professional | None | $3,388.44 | $3,388.44 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $5,754.40 Median $5,754.40 Typical High $7,244.36 | Facility | None | $5,754.40 | $5,754.40 | $7,244.36 |
Cigna Setting Professional Modifier None Typical Low $6,456.54 Median $9,332.54 Typical High $11,481.54 | Professional | None | $6,456.54 | $9,332.54 | $11,481.54 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $4,897.79 Typical High $5,754.40 | Facility | None | $758.58 | $4,897.79 | $5,754.40 |
Medica Setting Professional Modifier None Typical Low $4,168.69 Median $9,332.54 Typical High $31,622.78 | Professional | None | $4,168.69 | $9,332.54 | $31,622.78 |
Midlands Setting Professional Modifier None Typical Low $9,332.54 Median $9,332.54 Typical High $9,332.54 | Professional | None | $9,332.54 | $9,332.54 | $9,332.54 |
Midlands Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $7,943.28 | Professional | None | $7,943.28 | $7,943.28 | $7,943.28 |
Sanford Health Plan Setting Professional Modifier None Typical Low $4,168.69 Median $5,888.44 Typical High $8,128.31 | Professional | None | $4,168.69 | $5,888.44 | $8,128.31 |
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 $3,981.07 Median $7,762.47 Typical High $11,220.18 | Professional | None | $3,981.07 | $7,762.47 | $11,220.18 |
Wellmark Setting Professional Modifier None Typical Low $8,709.64 Median $10,000.00 Typical High $10,000.00 | Professional | None | $8,709.64 | $10,000.00 | $10,000.00 |
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 $1,698.24 Median $1,698.24 Typical High $2,041.74 | Professional | 52 · Reduced service | $1,698.24 | $1,698.24 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $676.08 Typical High $831.76 | Professional | 53 · Discontinued | $676.08 | $676.08 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,570.40 Median $2,570.40 Typical High $3,090.30 | Professional | 54 · Surgery only | $2,570.40 | $2,570.40 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $512.86 Median $512.86 Typical High $616.60 | Professional | 55 · Aftercare only | $512.86 | $512.86 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $338.84 Typical High $416.87 | Professional | 56 · Pre-op care only | $338.84 | $338.84 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,398.83 Median $2,398.83 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $2,398.83 | $2,398.83 | $2,884.03 |
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· 4th of 51
$8,710
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.