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 $1,445.44 Median $4,365.16 Typical High $4,897.79 | Facility | None | $1,445.44 | $4,365.16 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,445.44 | Professional | None | $1,202.26 | $1,202.26 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,511.89 | Facility | None | $2,041.74 | $2,041.74 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $2,290.87 Median $3,235.94 Typical High $4,073.80 | Professional | None | $2,290.87 | $3,235.94 | $4,073.80 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,737.80 Typical High $2,041.74 | Facility | None | $758.58 | $1,737.80 | $2,041.74 |
Medica Setting Professional Modifier None Typical Low $1,513.56 Median $3,311.31 Typical High $10,715.19 | Professional | None | $1,513.56 | $3,311.31 | $10,715.19 |
Midlands Setting Professional Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Professional | None | $3,311.31 | $3,311.31 | $3,311.31 |
Midlands Setting Professional Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,884.03 | $2,884.03 | $2,884.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,445.44 Median $2,089.30 Typical High $2,884.03 | Professional | None | $1,445.44 | $2,089.30 | $2,884.03 |
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 $1,412.54 Median $2,754.23 Typical High $3,981.07 | Professional | None | $1,412.54 | $2,754.23 | $3,981.07 |
Wellmark Setting Professional Modifier None Typical Low $3,090.30 Median $3,548.13 Typical High $3,548.13 | Professional | None | $3,090.30 | $3,548.13 | $3,548.13 |
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 $602.56 Median $602.56 Typical High $724.44 | Professional | 52 · Reduced service | $602.56 | $602.56 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $239.88 Typical High $288.40 | Professional | 53 · Discontinued | $239.88 | $239.88 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $891.25 Typical High $1,096.48 | Professional | 54 · Surgery only | $891.25 | $891.25 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $177.83 Typical High $218.78 | Professional | 55 · Aftercare only | $177.83 | $177.83 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $120.23 Typical High $144.54 | Professional | 56 · Pre-op care only | $120.23 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $831.76 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $831.76 | $831.76 | $1,023.29 |
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· 5th of 51
$3,090
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.