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 $1,698.24 Median $1,698.24 Typical High $4,365.16 | Facility | None | $1,698.24 | $1,698.24 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $1,412.54 Median $1,412.54 Typical High $1,778.28 | Professional | None | $1,412.54 | $1,412.54 | $1,778.28 |
Cigna Setting Facility Modifier None Typical Low $2,398.83 Median $2,398.83 Typical High $2,951.21 | Facility | None | $2,398.83 | $2,398.83 | $2,951.21 |
Cigna Setting Professional Modifier None Typical Low $2,691.53 Median $3,801.89 Typical High $4,786.30 | Professional | None | $2,691.53 | $3,801.89 | $4,786.30 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $2,041.74 Typical High $2,398.83 | Facility | None | $758.58 | $2,041.74 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $1,819.70 Median $3,890.45 Typical High $12,589.25 | Professional | None | $1,819.70 | $3,890.45 | $12,589.25 |
Midlands Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Midlands Setting Professional Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Professional | None | $3,630.78 | $3,630.78 | $3,630.78 |
Sanford Health Plan Setting Professional Modifier None Typical Low $2,041.74 Median $2,454.71 Typical High $3,388.44 | Professional | None | $2,041.74 | $2,454.71 | $3,388.44 |
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 $1,659.59 Median $3,311.31 Typical High $4,677.35 | Professional | None | $1,659.59 | $3,311.31 | $4,677.35 |
Wellmark Setting Professional Modifier None Typical Low $3,548.13 Median $4,168.69 Typical High $4,168.69 | Professional | None | $3,548.13 | $4,168.69 | $4,168.69 |
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 $707.95 Median $707.95 Typical High $851.14 | Professional | 52 · Reduced service | $707.95 | $707.95 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $281.84 Median $281.84 Typical High $338.84 | Professional | 53 · Discontinued | $281.84 | $281.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,047.13 Median $1,047.13 Typical High $1,288.25 | Professional | 54 · Surgery only | $1,047.13 | $1,047.13 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $208.93 Typical High $257.04 | Professional | 55 · Aftercare only | $208.93 | $208.93 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | 56 · Pre-op care only | $141.25 | $141.25 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $977.24 Median $977.24 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $977.24 | $977.24 | $1,202.26 |
Where South Dakota sits
The same service costs 5.4 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
$3,548
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.