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 $204.17 Median $251.19 Typical High $4,365.16 | Facility | None | $204.17 | $251.19 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $181.97 Median $223.87 Typical High $302.00 | Professional | None | $181.97 | $223.87 | $302.00 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $1,202.26 Typical High $1,513.56 | Facility | None | $407.38 | $1,202.26 | $1,513.56 |
Cigna Setting Professional Modifier None Typical Low $457.09 Median $537.03 Typical High $812.83 | Professional | None | $457.09 | $537.03 | $812.83 |
Medica Setting Facility Modifier None Typical Low $281.84 Median $407.38 Typical High $1,202.26 | Facility | None | $281.84 | $407.38 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $223.87 Median $676.08 Typical High $2,089.30 | Professional | None | $223.87 | $676.08 | $2,089.30 |
Midlands Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $537.03 | Professional | None | $467.74 | $467.74 | $537.03 |
Midlands Setting Facility Modifier None Typical Low $1,096.48 Median $1,318.26 Typical High $1,819.70 | Facility | None | $1,096.48 | $1,318.26 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $416.87 Median $416.87 Typical High $467.74 | Professional | None | $416.87 | $416.87 | $467.74 |
Sanford Health Plan Setting Professional Modifier None Typical Low $263.03 Median $398.11 Typical High $512.86 | Professional | None | $263.03 | $398.11 | $512.86 |
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 $218.78 Median $549.54 Typical High $707.95 | Professional | None | $218.78 | $549.54 | $707.95 |
Wellmark Setting Professional Modifier None Typical Low $380.19 Median $467.74 Typical High $660.69 | Professional | None | $380.19 | $467.74 | $660.69 |
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 $91.20 Median $102.33 Typical High $128.82 | Professional | 52 · Reduced service | $91.20 | $102.33 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $36.31 Median $41.69 Typical High $51.29 | Professional | 53 · Discontinued | $36.31 | $41.69 | $51.29 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $134.90 Median $154.88 Typical High $194.98 | Professional | 54 · Surgery only | $134.90 | $154.88 | $194.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.92 Median $30.90 Typical High $38.90 | Professional | 55 · Aftercare only | $26.92 | $30.90 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.20 Median $20.42 Typical High $25.70 | Professional | 56 · Pre-op care only | $18.20 | $20.42 | $25.70 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $125.89 Median $144.54 Typical High $181.97 | Professional | 78 · Unplanned return to OR | $125.89 | $144.54 | $181.97 |
Where South Dakota sits
The same service costs 4.7 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
$468
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.