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 $102.33 Median $154.88 Typical High $4,365.16 | Facility | None | $102.33 | $154.88 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $114.82 Typical High $218.78 | Professional | None | $95.50 | $114.82 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $138.04 Typical High $338.84 | Facility | None | $83.18 | $138.04 | $338.84 |
Cigna Setting Professional Modifier None Typical Low $218.78 Median $309.03 Typical High $549.54 | Professional | None | $218.78 | $309.03 | $549.54 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $177.83 Typical High $275.42 | Facility | None | $125.89 | $177.83 | $275.42 |
Medica Setting Professional Modifier None Typical Low $131.83 Median $416.87 Typical High $1,380.38 | Professional | None | $131.83 | $416.87 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $218.78 Median $223.87 Typical High $309.03 | Professional | None | $218.78 | $223.87 | $309.03 |
Midlands Setting Facility Modifier None Typical Low $83.18 Median $120.23 Typical High $177.83 | Facility | None | $83.18 | $120.23 | $177.83 |
Midlands Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $257.04 | Professional | None | $190.55 | $190.55 | $257.04 |
Sanford Health Plan Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $338.84 | Professional | None | $144.54 | $213.80 | $338.84 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $107.15 Median $281.84 Typical High $436.52 | Professional | None | $107.15 | $281.84 | $436.52 |
Wellmark Setting Professional Modifier None Typical Low $199.53 Median $245.47 Typical High $446.68 | Professional | None | $199.53 | $245.47 | $446.68 |
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 $47.86 Median $51.29 Typical High $87.10 | Professional | 52 · Reduced service | $47.86 | $51.29 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $20.42 Typical High $34.67 | Professional | 53 · Discontinued | $19.05 | $20.42 | $34.67 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $70.79 Median $77.62 Typical High $131.83 | Professional | 54 · Surgery only | $70.79 | $77.62 | $131.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $15.49 Typical High $26.30 | Professional | 55 · Aftercare only | $14.13 | $15.49 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $10.23 Typical High $17.38 | Professional | 56 · Pre-op care only | $9.55 | $10.23 | $17.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $66.07 Median $72.44 Typical High $123.03 | Professional | 78 · Unplanned return to OR | $66.07 | $72.44 | $123.03 |
Where South Dakota sits
The same service costs 3.6 times more in Alaska than in Kentucky. 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· 8th of 51
$245
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.