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 $588.84 Median $588.84 Typical High $4,365.16 | Facility | None | $588.84 | $588.84 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $501.19 Median $501.19 Typical High $794.33 | Professional | None | $501.19 | $501.19 | $794.33 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $2,238.72 Typical High $2,511.89 | Facility | None | $851.14 | $2,238.72 | $2,511.89 |
Cigna Setting Professional Modifier None Typical Low $954.99 Median $1,348.96 Typical High $1,698.24 | Professional | None | $954.99 | $1,348.96 | $1,698.24 |
Medica Setting Facility Modifier None Typical Low $724.44 Median $1,380.38 Typical High $2,398.83 | Facility | None | $724.44 | $1,380.38 | $2,398.83 |
Medica Setting Professional Modifier None Typical Low $630.96 Median $1,348.96 Typical High $4,677.35 | Professional | None | $630.96 | $1,348.96 | $4,677.35 |
Midlands Setting Professional Modifier None Typical Low $1,348.96 Median $1,348.96 Typical High $1,380.38 | Professional | None | $1,348.96 | $1,348.96 | $1,380.38 |
Midlands Setting Facility Modifier None Typical Low $1,995.26 Median $2,398.83 Typical High $2,570.40 | Facility | None | $1,995.26 | $2,398.83 | $2,570.40 |
Midlands Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Sanford Health Plan Setting Professional Modifier None Typical Low $724.44 Median $870.96 Typical High $1,202.26 | Professional | None | $724.44 | $870.96 | $1,202.26 |
United Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $2,398.83 | Facility | None | $1,995.26 | $1,995.26 | $2,398.83 |
United Setting Professional Modifier None Typical Low $575.44 Median $1,148.15 Typical High $1,621.81 | Professional | None | $575.44 | $1,148.15 | $1,621.81 |
Wellmark Setting Professional Modifier None Typical Low $1,288.25 Median $1,513.56 Typical High $1,513.56 | Professional | None | $1,288.25 | $1,513.56 | $1,513.56 |
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 $251.19 Median $251.19 Typical High $295.12 | Professional | 52 · Reduced service | $251.19 | $251.19 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $100.00 Median $100.00 Typical High $117.49 | Professional | 53 · Discontinued | $100.00 | $100.00 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $371.54 Median $371.54 Typical High $446.68 | Professional | 54 · Surgery only | $371.54 | $371.54 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | 55 · Aftercare only | $74.13 | $74.13 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $50.12 Median $50.12 Typical High $58.88 | Professional | 56 · Pre-op care only | $50.12 | $50.12 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $346.74 Median $346.74 Typical High $416.87 | Professional | 78 · Unplanned return to OR | $346.74 | $346.74 | $416.87 |
Where South Dakota sits
The same service costs 5.9 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
$1,349
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.