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 $107.15 Median $141.25 Typical High $4,365.16 | Facility | None | $107.15 | $141.25 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $120.23 Typical High $194.98 | Professional | None | $100.00 | $120.23 | $194.98 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $154.88 Typical High $309.03 | Facility | None | $79.43 | $154.88 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $489.78 | Professional | None | $234.42 | $309.03 | $489.78 |
Medica Setting Facility Modifier None Typical Low $154.88 Median $245.47 Typical High $1,698.24 | Facility | None | $154.88 | $245.47 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $123.03 Median $316.23 Typical High $1,584.89 | Professional | None | $123.03 | $316.23 | $1,584.89 |
Midlands Setting Professional Modifier None Typical Low $234.42 Median $234.42 Typical High $281.84 | Professional | None | $234.42 | $234.42 | $281.84 |
Midlands Setting Facility Modifier None Typical Low $79.43 Median $109.65 Typical High $181.97 | Facility | None | $79.43 | $109.65 | $181.97 |
Midlands Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $239.88 | Professional | None | $204.17 | $204.17 | $239.88 |
Sanford Health Plan Setting Professional Modifier None Typical Low $134.90 Median $218.78 Typical High $309.03 | Professional | None | $134.90 | $218.78 | $309.03 |
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 $114.82 Median $288.40 Typical High $398.11 | Professional | None | $114.82 | $288.40 | $398.11 |
Wellmark Setting Professional Modifier None Typical Low $208.93 Median $257.04 Typical High $398.11 | Professional | None | $208.93 | $257.04 | $398.11 |
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 $50.12 Median $53.70 Typical High $79.43 | Professional | 52 · Reduced service | $50.12 | $53.70 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $21.88 Typical High $31.62 | Professional | 53 · Discontinued | $19.95 | $21.88 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $81.28 Typical High $117.49 | Professional | 54 · Surgery only | $74.13 | $81.28 | $117.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $16.22 Typical High $23.44 | Professional | 55 · Aftercare only | $14.79 | $16.22 | $23.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $10.96 Typical High $15.85 | Professional | 56 · Pre-op care only | $10.00 | $10.96 | $15.85 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $75.86 Typical High $109.65 | Professional | 78 · Unplanned return to OR | $69.18 | $75.86 | $109.65 |
Where South Dakota sits
The same service costs 3.7 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
$257
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.