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 $1,096.48 Median $3,090.30 Typical High $4,365.16 | Facility | None | $1,096.48 | $3,090.30 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $933.25 Typical High $1,202.26 | Professional | None | $933.25 | $933.25 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $1,584.89 Median $1,949.84 Typical High $2,187.76 | Facility | None | $1,584.89 | $1,949.84 | $2,187.76 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,511.89 Typical High $3,162.28 | Professional | None | $1,819.70 | $2,511.89 | $3,162.28 |
Medica Setting Facility Modifier None Typical Low $1,230.27 Median $1,995.26 Typical High $2,570.40 | Facility | None | $1,230.27 | $1,995.26 | $2,570.40 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $2,511.89 Typical High $8,128.31 | Professional | None | $1,096.48 | $2,511.89 | $8,128.31 |
Midlands Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $2,511.89 | Professional | None | $2,511.89 | $2,511.89 | $2,511.89 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,862.09 Typical High $2,187.76 | Facility | None | $954.99 | $1,862.09 | $2,187.76 |
Midlands Setting Professional Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Professional | None | $2,290.87 | $2,290.87 | $2,290.87 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,071.52 Median $1,584.89 Typical High $2,137.96 | Professional | None | $1,071.52 | $1,584.89 | $2,137.96 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Facility | None | $1,995.26 | $1,995.26 | $2,398.83 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $2,187.76 Typical High $3,019.95 | Professional | None | $1,023.29 | $2,187.76 | $3,019.95 |
Wellmark Setting Professional Modifier None Typical Low $2,290.87 Median $2,691.53 Typical High $2,691.53 | Professional | None | $2,290.87 | $2,691.53 | $2,691.53 |
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 $467.74 Median $467.74 Typical High $549.54 | Professional | 52 · Reduced service | $467.74 | $467.74 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $186.21 Typical High $218.78 | Professional | 53 · Discontinued | $186.21 | $186.21 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $831.76 | Professional | 54 · Surgery only | $707.95 | $707.95 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $165.96 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $93.33 Typical High $109.65 | Professional | 56 · Pre-op care only | $93.33 | $93.33 | $109.65 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $776.25 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $776.25 |
Where South Dakota sits
The same service costs 5.2 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
$2,291
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.