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 $125.89 Median $165.96 Typical High $4,365.16 | Facility | None | $125.89 | $165.96 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $134.90 Typical High $223.87 | Professional | None | $114.82 | $134.90 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $169.82 Typical High $354.81 | Facility | None | $87.10 | $169.82 | $354.81 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $354.81 Typical High $562.34 | Professional | None | $275.42 | $354.81 | $562.34 |
Medica Setting Facility Modifier None Typical Low $177.83 Median $281.84 Typical High $1,202.26 | Facility | None | $177.83 | $281.84 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $436.52 Typical High $1,445.44 | Professional | None | $141.25 | $436.52 | $1,445.44 |
Midlands Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $331.13 | Professional | None | $275.42 | $275.42 | $331.13 |
Midlands Setting Facility Modifier None Typical Low $87.10 Median $125.89 Typical High $204.17 | Facility | None | $87.10 | $125.89 | $204.17 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $239.88 Typical High $275.42 | Professional | None | $239.88 | $239.88 | $275.42 |
Sanford Health Plan Setting Professional Modifier None Typical Low $154.88 Median $251.19 Typical High $354.81 | Professional | None | $154.88 | $251.19 | $354.81 |
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 $128.82 Median $331.13 Typical High $457.09 | Professional | None | $128.82 | $331.13 | $457.09 |
Wellmark Setting Professional Modifier None Typical Low $239.88 Median $295.12 Typical High $457.09 | Professional | None | $239.88 | $295.12 | $457.09 |
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 $57.54 Median $63.10 Typical High $91.20 | Professional | 52 · Reduced service | $57.54 | $63.10 | $91.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $25.12 Typical High $36.31 | Professional | 53 · Discontinued | $22.91 | $25.12 | $36.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $93.33 Typical High $134.90 | Professional | 54 · Surgery only | $87.10 | $93.33 | $134.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $19.05 Typical High $26.92 | Professional | 55 · Aftercare only | $17.38 | $19.05 | $26.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.59 Typical High $18.20 | Professional | 56 · Pre-op care only | $11.48 | $12.59 | $18.20 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $81.28 Median $87.10 Typical High $125.89 | Professional | 78 · Unplanned return to OR | $81.28 | $87.10 | $125.89 |
Where South Dakota sits
The same service costs 3.9 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· 6th of 51
$295
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.