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 $602.56 Median $3,548.13 Typical High $4,365.16 | Facility | None | $602.56 | $3,548.13 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $602.56 | Professional | None | $512.86 | $512.86 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $870.96 Median $1,698.24 Typical High $1,949.84 | Facility | None | $870.96 | $1,698.24 | $1,949.84 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,380.38 Typical High $1,737.80 | Professional | None | $1,000.00 | $1,380.38 | $1,737.80 |
Medica Setting Facility Modifier None Typical Low $691.83 Median $1,412.54 Typical High $1,819.70 | Facility | None | $691.83 | $1,412.54 | $1,819.70 |
Medica Setting Professional Modifier None Typical Low $588.84 Median $1,380.38 Typical High $4,466.84 | Professional | None | $588.84 | $1,380.38 | $4,466.84 |
Midlands Setting Professional Modifier None Typical Low $1,380.38 Median $1,380.38 Typical High $1,412.54 | Professional | None | $1,380.38 | $1,380.38 | $1,412.54 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,698.24 Typical High $2,137.96 | Facility | None | $1,096.48 | $1,698.24 | $2,137.96 |
Midlands Setting Professional Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,230.27 | $1,230.27 | $1,230.27 |
Sanford Health Plan Setting Professional Modifier None Typical Low $660.69 Median $891.25 Typical High $1,230.27 | Professional | None | $660.69 | $891.25 | $1,230.27 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,513.56 | $1,513.56 | $1,819.70 |
United Setting Professional Modifier None Typical Low $588.84 Median $1,148.15 Typical High $1,659.59 | Professional | None | $588.84 | $1,148.15 | $1,659.59 |
Wellmark Setting Professional Modifier None Typical Low $1,348.96 Median $1,584.89 Typical High $1,584.89 | Professional | None | $1,348.96 | $1,584.89 | $1,584.89 |
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 $257.04 Median $257.04 Typical High $302.00 | Professional | 52 · Reduced service | $257.04 | $257.04 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $102.33 Median $102.33 Typical High $120.23 | Professional | 53 · Discontinued | $102.33 | $102.33 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $380.19 Median $380.19 Typical High $457.09 | Professional | 54 · Surgery only | $380.19 | $380.19 | $457.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $77.62 Median $77.62 Typical High $91.20 | Professional | 55 · Aftercare only | $77.62 | $77.62 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $51.29 Median $51.29 Typical High $60.26 | Professional | 56 · Pre-op care only | $51.29 | $51.29 | $60.26 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $354.81 Median $354.81 Typical High $426.58 | Professional | 78 · Unplanned return to OR | $354.81 | $354.81 | $426.58 |
Where South Dakota sits
The same service costs 5.6 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
$1,380
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.