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 $1,148.15 Median $1,148.15 Typical High $4,365.16 | Facility | None | $1,148.15 | $1,148.15 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $1,148.15 | Professional | None | $954.99 | $954.99 | $1,148.15 |
Cigna Setting Facility Modifier None Typical Low $1,621.81 Median $1,621.81 Typical High $1,995.26 | Facility | None | $1,621.81 | $1,621.81 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $1,819.70 Median $2,570.40 Typical High $3,235.94 | Professional | None | $1,819.70 | $2,570.40 | $3,235.94 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,348.96 Typical High $1,995.26 | Facility | None | $758.58 | $1,348.96 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $1,122.02 Median $2,630.27 Typical High $8,511.38 | Professional | None | $1,122.02 | $2,630.27 | $8,511.38 |
Midlands Setting Professional Modifier None Typical Low $2,630.27 Median $2,630.27 Typical High $2,630.27 | Professional | None | $2,630.27 | $2,630.27 | $2,630.27 |
Midlands Setting Professional Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,398.83 | Professional | None | $2,398.83 | $2,398.83 | $2,398.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,148.15 Median $1,659.59 Typical High $2,290.87 | Professional | None | $1,148.15 | $1,659.59 | $2,290.87 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $2,238.72 Typical High $3,162.28 | Professional | None | $1,096.48 | $2,238.72 | $3,162.28 |
Wellmark Setting Professional Modifier None Typical Low $2,454.71 Median $2,818.38 Typical High $2,818.38 | Professional | None | $2,454.71 | $2,818.38 | $2,818.38 |
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 $478.63 Median $478.63 Typical High $575.44 | Professional | 52 · Reduced service | $478.63 | $478.63 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $190.55 Median $190.55 Typical High $229.09 | Professional | 53 · Discontinued | $190.55 | $190.55 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $707.95 Typical High $851.14 | Professional | 54 · Surgery only | $707.95 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | 55 · Aftercare only | $141.25 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $95.50 Typical High $114.82 | Professional | 56 · Pre-op care only | $95.50 | $95.50 | $114.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $660.69 Typical High $794.33 | Professional | 78 · Unplanned return to OR | $660.69 | $660.69 | $794.33 |
Where South Dakota sits
The same service costs 5.5 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
$2,455
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.