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 $1,230.27 Median $1,230.27 Typical High $4,365.16 | Facility | None | $1,230.27 | $1,230.27 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,230.27 | Professional | None | $1,023.29 | $1,023.29 | $1,230.27 |
Cigna Setting Facility Modifier None Typical Low $1,737.80 Median $2,187.76 Typical High $6,918.31 | Facility | None | $1,737.80 | $2,187.76 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $1,949.84 Median $2,754.23 Typical High $3,467.37 | Professional | None | $1,949.84 | $2,754.23 | $3,467.37 |
Medica Setting Facility Modifier None Typical Low $1,584.89 Median $2,818.38 Typical High $4,786.30 | Facility | None | $1,584.89 | $2,818.38 | $4,786.30 |
Medica Setting Professional Modifier None Typical Low $1,318.26 Median $2,754.23 Typical High $9,120.11 | Professional | None | $1,318.26 | $2,754.23 | $9,120.11 |
Midlands Setting Professional Modifier None Typical Low $2,754.23 Median $2,754.23 Typical High $2,818.38 | Professional | None | $2,754.23 | $2,754.23 | $2,818.38 |
Midlands Setting Facility Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $8,317.64 | Facility | None | $6,918.31 | $6,918.31 | $8,317.64 |
Midlands Setting Professional Modifier None Typical Low $2,454.71 Median $2,454.71 Typical High $2,454.71 | Professional | None | $2,454.71 | $2,454.71 | $2,454.71 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,230.27 Median $1,819.70 Typical High $2,454.71 | Professional | None | $1,230.27 | $1,819.70 | $2,454.71 |
United Setting Facility Modifier None Typical Low $3,981.07 Median $3,981.07 Typical High $4,786.30 | Facility | None | $3,981.07 | $3,981.07 | $4,786.30 |
United Setting Professional Modifier None Typical Low $1,202.26 Median $2,398.83 Typical High $3,388.44 | Professional | None | $1,202.26 | $2,398.83 | $3,388.44 |
Wellmark Setting Professional Modifier None Typical Low $2,630.27 Median $3,019.95 Typical High $3,019.95 | Professional | None | $2,630.27 | $3,019.95 | $3,019.95 |
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 $512.86 Median $512.86 Typical High $616.60 | Professional | 52 · Reduced service | $512.86 | $512.86 | $616.60 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $204.17 Median $204.17 Typical High $245.47 | Professional | 53 · Discontinued | $204.17 | $204.17 | $245.47 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $758.58 Median $758.58 Typical High $912.01 | Professional | 54 · Surgery only | $758.58 | $758.58 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $154.88 Median $154.88 Typical High $186.21 | Professional | 55 · Aftercare only | $154.88 | $154.88 | $186.21 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $102.33 Median $102.33 Typical High $123.03 | Professional | 56 · Pre-op care only | $102.33 | $102.33 | $123.03 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $707.95 Median $707.95 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $707.95 | $707.95 | $851.14 |
Where South Dakota sits
The same service costs 25.7 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
$2,754
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.