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 $3,467.37 Median $3,467.37 Typical High $4,365.16 | Facility | None | $3,467.37 | $3,467.37 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $3,467.37 | Professional | None | $2,884.03 | $2,884.03 | $3,467.37 |
Cigna Setting Facility Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $6,165.95 | Facility | None | $4,897.79 | $4,897.79 | $6,165.95 |
Cigna Setting Professional Modifier None Typical Low $5,495.41 Median $7,762.47 Typical High $9,772.37 | Professional | None | $5,495.41 | $7,762.47 | $9,772.37 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $4,073.80 Typical High $4,897.79 | Facility | None | $758.58 | $4,073.80 | $4,897.79 |
Medica Setting Professional Modifier None Typical Low $3,630.78 Median $7,943.28 Typical High $25,703.96 | Professional | None | $3,630.78 | $7,943.28 | $25,703.96 |
Midlands Setting Professional Modifier None Typical Low $7,943.28 Median $7,943.28 Typical High $8,128.31 | Professional | None | $7,943.28 | $7,943.28 | $8,128.31 |
Midlands Setting Professional Modifier None Typical Low $7,079.46 Median $7,079.46 Typical High $7,079.46 | Professional | None | $7,079.46 | $7,079.46 | $7,079.46 |
Sanford Health Plan Setting Professional Modifier None Typical Low $3,890.45 Median $5,248.07 Typical High $6,918.31 | Professional | None | $3,890.45 | $5,248.07 | $6,918.31 |
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 $3,388.44 Median $6,606.93 Typical High $9,549.93 | Professional | None | $3,388.44 | $6,606.93 | $9,549.93 |
Wellmark Setting Professional Modifier None Typical Low $7,413.10 Median $8,511.38 Typical High $8,511.38 | Professional | None | $7,413.10 | $8,511.38 | $8,511.38 |
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 $1,445.44 Median $1,445.44 Typical High $1,737.80 | Professional | 52 · Reduced service | $1,445.44 | $1,445.44 | $1,737.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $575.44 Median $575.44 Typical High $691.83 | Professional | 53 · Discontinued | $575.44 | $575.44 | $691.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,187.76 Median $2,187.76 Typical High $2,630.27 | Professional | 54 · Surgery only | $2,187.76 | $2,187.76 | $2,630.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $436.52 Median $436.52 Typical High $524.81 | Professional | 55 · Aftercare only | $436.52 | $436.52 | $524.81 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $288.40 Median $288.40 Typical High $346.74 | Professional | 56 · Pre-op care only | $288.40 | $288.40 | $346.74 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,041.74 Median $2,041.74 Typical High $2,454.71 | Professional | 78 · Unplanned return to OR | $2,041.74 | $2,041.74 | $2,454.71 |
Where South Dakota sits
The same service costs 27.5 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
$7,079
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.