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 $208.93 Typical High $4,365.16 | Facility | None | $186.21 | $208.93 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $186.21 Typical High $501.19 | Professional | None | $158.49 | $186.21 | $501.19 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $1,174.90 Typical High $2,238.72 | Facility | None | $309.03 | $1,174.90 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $616.60 | Professional | None | $380.19 | $478.63 | $616.60 |
Medica Setting Facility Modifier None Typical Low $263.03 Median $309.03 Typical High $1,698.24 | Facility | None | $263.03 | $309.03 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $213.80 Median $562.34 Typical High $2,238.72 | Professional | None | $213.80 | $562.34 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $426.58 Median $426.58 Typical High $478.63 | Professional | None | $426.58 | $426.58 | $478.63 |
Midlands Setting Facility Modifier None Typical Low $954.99 Median $1,412.54 Typical High $2,344.23 | Facility | None | $954.99 | $1,412.54 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $436.52 | Professional | None | $380.19 | $380.19 | $436.52 |
Sanford Health Plan Setting Professional Modifier None Typical Low $223.87 Median $338.84 Typical High $416.87 | Professional | None | $223.87 | $338.84 | $416.87 |
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 $199.53 Median $489.78 Typical High $575.44 | Professional | None | $199.53 | $489.78 | $575.44 |
Wellmark Setting Professional Modifier None Typical Low $338.84 Median $416.87 Typical High $537.03 | Professional | None | $338.84 | $416.87 | $537.03 |
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 $79.43 Median $91.20 Typical High $107.15 | Professional | 52 · Reduced service | $79.43 | $91.20 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $37.15 Typical High $42.66 | Professional | 53 · Discontinued | $31.62 | $37.15 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $138.04 Typical High $162.18 | Professional | 54 · Surgery only | $120.23 | $138.04 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $27.54 Typical High $32.36 | Professional | 55 · Aftercare only | $23.99 | $27.54 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $18.62 Typical High $21.38 | Professional | 56 · Pre-op care only | $15.85 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $128.82 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $112.20 | $128.82 | $151.36 |
Where South Dakota sits
The same service costs 5.9 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
$427
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.