How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $134.90 Median $239.88 Typical High $4,365.16 | Facility | None | $134.90 | $239.88 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $117.49 Median $208.93 Typical High $354.81 | Professional | None | $117.49 | $208.93 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $251.19 Typical High $457.09 | Facility | None | $194.98 | $251.19 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $407.38 Typical High $660.69 | Professional | None | $281.84 | $407.38 | $660.69 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $199.53 Typical High $354.81 | Facility | None | $125.89 | $199.53 | $354.81 |
Medica Setting Professional Modifier None Typical Low $257.04 Median $537.03 Typical High $1,778.28 | Professional | None | $257.04 | $537.03 | $1,778.28 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $346.74 Typical High $537.03 | Professional | None | $316.23 | $346.74 | $537.03 |
Midlands Setting Facility Modifier None Typical Low $194.98 Median $245.47 Typical High $323.59 | Facility | None | $194.98 | $245.47 | $323.59 |
Midlands Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $489.78 | Professional | None | $281.84 | $281.84 | $489.78 |
Sanford Health Plan Setting Professional Modifier None Typical Low $190.55 Median $295.12 Typical High $446.68 | Professional | None | $190.55 | $295.12 | $446.68 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $165.96 Median $354.81 Typical High $660.69 | Professional | None | $165.96 | $354.81 | $660.69 |
Wellmark Setting Professional Modifier None Typical Low $295.12 Median $338.84 Typical High $691.83 | Professional | None | $295.12 | $338.84 | $691.83 |
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 $58.88 Median $104.71 Typical High $117.49 | Professional | 52 · Reduced service | $58.88 | $104.71 | $117.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $41.69 Typical High $46.77 | Professional | 53 · Discontinued | $23.44 | $41.69 | $46.77 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $158.49 Typical High $177.83 | Professional | 54 · Surgery only | $89.13 | $158.49 | $177.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $31.62 Typical High $35.48 | Professional | 55 · Aftercare only | $17.78 | $31.62 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $20.89 Typical High $23.44 | Professional | 56 · Pre-op care only | $11.75 | $20.89 | $23.44 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $147.91 Typical High $165.96 | Professional | 78 · Unplanned return to OR | $83.18 | $147.91 | $165.96 |
Where South Dakota sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 9th of 51
$339
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.