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 $1,047.13 Median $1,047.13 Typical High $4,365.16 | Facility | None | $1,047.13 | $1,047.13 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $870.96 Median $870.96 Typical High $1,047.13 | Professional | None | $870.96 | $870.96 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $1,479.11 Median $1,479.11 Typical High $1,819.70 | Facility | None | $1,479.11 | $1,479.11 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,659.59 Median $2,344.23 Typical High $2,951.21 | Professional | None | $1,659.59 | $2,344.23 | $2,951.21 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,288.25 Typical High $1,995.26 | Facility | None | $758.58 | $1,288.25 | $1,995.26 |
Medica Setting Professional Modifier None Typical Low $1,096.48 Median $2,344.23 Typical High $7,762.47 | Professional | None | $1,096.48 | $2,344.23 | $7,762.47 |
Midlands Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,398.83 | Professional | None | $2,344.23 | $2,344.23 | $2,398.83 |
Midlands Setting Professional Modifier None Typical Low $2,187.76 Median $2,187.76 Typical High $2,187.76 | Professional | None | $2,187.76 | $2,187.76 | $2,187.76 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,258.93 Median $1,513.56 Typical High $2,089.30 | Professional | None | $1,258.93 | $1,513.56 | $2,089.30 |
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 $1,000.00 Median $1,995.26 Typical High $2,884.03 | Professional | None | $1,000.00 | $1,995.26 | $2,884.03 |
Wellmark Setting Professional Modifier None Typical Low $2,238.72 Median $2,570.40 Typical High $2,570.40 | Professional | None | $2,238.72 | $2,570.40 | $2,570.40 |
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 $436.52 Median $436.52 Typical High $512.86 | Professional | 52 · Reduced service | $436.52 | $436.52 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $173.78 Median $173.78 Typical High $208.93 | Professional | 53 · Discontinued | $173.78 | $173.78 | $208.93 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $645.65 Median $645.65 Typical High $776.25 | Professional | 54 · Surgery only | $645.65 | $645.65 | $776.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $128.82 Median $128.82 Typical High $154.88 | Professional | 55 · Aftercare only | $128.82 | $128.82 | $154.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | 56 · Pre-op care only | $87.10 | $87.10 | $104.71 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $602.56 Median $602.56 Typical High $724.44 | Professional | 78 · Unplanned return to OR | $602.56 | $602.56 | $724.44 |
Where South Dakota sits
The same service costs 24.5 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
$2,239
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.