How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). 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 $186.21 Median $223.87 Typical High $4,365.16 | Facility | None | $186.21 | $223.87 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $162.18 Median $199.53 Typical High $229.09 | Professional | None | $162.18 | $199.53 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,174.90 Typical High $1,412.54 | Facility | None | $331.13 | $1,174.90 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $660.69 | Professional | None | $389.05 | $512.86 | $660.69 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $338.84 Typical High $1,698.24 | Facility | None | $269.15 | $338.84 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $234.42 Median $602.56 Typical High $2,187.76 | Professional | None | $234.42 | $602.56 | $2,187.76 |
Midlands Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $512.86 | Professional | None | $436.52 | $436.52 | $512.86 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,258.93 Typical High $1,412.54 | Facility | None | $954.99 | $1,258.93 | $1,412.54 |
Midlands Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $446.68 | Professional | None | $389.05 | $389.05 | $446.68 |
Sanford Health Plan Setting Professional Modifier None Typical Low $269.15 Median $354.81 Typical High $436.52 | Professional | None | $269.15 | $354.81 | $436.52 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,513.56 | $1,513.56 | $1,819.70 |
United Setting Professional Modifier None Typical Low $204.17 Median $501.19 Typical High $630.96 | Professional | None | $204.17 | $501.19 | $630.96 |
Wellmark Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $562.34 | Professional | None | $338.84 | $416.87 | $562.34 |
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 $81.28 Median $93.33 Typical High $114.82 | Professional | 52 · Reduced service | $81.28 | $93.33 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $38.02 Typical High $45.71 | Professional | 53 · Discontinued | $32.36 | $38.02 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $141.25 Typical High $173.78 | Professional | 54 · Surgery only | $120.23 | $141.25 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $28.18 Typical High $34.67 | Professional | 55 · Aftercare only | $23.99 | $28.18 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $18.62 Typical High $22.91 | Professional | 56 · Pre-op care only | $16.22 | $18.62 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $131.83 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $112.20 | $131.83 | $162.18 |
Where South Dakota sits
The same service costs 5.6 times more in Oklahoma than in Utah. 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· 7th of 51
$437
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.