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 $173.78 Median $223.87 Typical High $4,365.16 | Facility | None | $173.78 | $223.87 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $190.55 Typical High $251.19 | Professional | None | $147.91 | $190.55 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $331.13 Median $1,202.26 Typical High $1,348.96 | Facility | None | $331.13 | $1,202.26 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $501.19 Typical High $660.69 | Professional | None | $380.19 | $501.19 | $660.69 |
Medica Setting Facility Modifier None Typical Low $229.09 Median $323.59 Typical High $1,202.26 | Facility | None | $229.09 | $323.59 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $208.93 Median $588.84 Typical High $2,344.23 | Professional | None | $208.93 | $588.84 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $501.19 | Professional | None | $398.11 | $398.11 | $501.19 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $1,288.25 Typical High $1,513.56 | Facility | None | $645.65 | $1,288.25 | $1,513.56 |
Midlands Setting Professional Modifier None Typical Low $354.81 Median $354.81 Typical High $457.09 | Professional | None | $354.81 | $354.81 | $457.09 |
Sanford Health Plan Setting Professional Modifier None Typical Low $257.04 Median $323.59 Typical High $436.52 | Professional | None | $257.04 | $323.59 | $436.52 |
United Setting Facility Modifier None Typical Low $758.58 Median $891.25 Typical High $1,698.24 | Facility | None | $758.58 | $891.25 | $1,698.24 |
United Setting Professional Modifier None Typical Low $190.55 Median $457.09 Typical High $616.60 | Professional | None | $190.55 | $457.09 | $616.60 |
Wellmark Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $549.54 | Professional | None | $302.00 | $371.54 | $549.54 |
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 $74.13 Median $85.11 Typical High $107.15 | Professional | 52 · Reduced service | $74.13 | $85.11 | $107.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $29.51 Median $34.67 Typical High $42.66 | Professional | 53 · Discontinued | $29.51 | $34.67 | $42.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $109.65 Median $128.82 Typical High $162.18 | Professional | 54 · Surgery only | $109.65 | $128.82 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $21.88 Median $25.70 Typical High $32.36 | Professional | 55 · Aftercare only | $21.88 | $25.70 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $17.38 Typical High $21.38 | Professional | 56 · Pre-op care only | $14.79 | $17.38 | $21.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $102.33 Median $120.23 Typical High $151.36 | Professional | 78 · Unplanned return to OR | $102.33 | $120.23 | $151.36 |
Where South Dakota sits
The same service costs 4.6 times more in Alaska 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
$398
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.