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 $177.83 Median $223.87 Typical High $4,365.16 | Facility | None | $177.83 | $223.87 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $398.11 | Professional | None | $158.49 | $190.55 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $1,348.96 Typical High $2,137.96 | Facility | None | $354.81 | $1,348.96 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $467.74 Typical High $707.95 | Professional | None | $407.38 | $467.74 | $707.95 |
Medica Setting Facility Modifier None Typical Low $269.15 Median $363.08 Typical High $1,698.24 | Facility | None | $269.15 | $363.08 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $194.98 Median $537.03 Typical High $3,162.28 | Professional | None | $194.98 | $537.03 | $3,162.28 |
Midlands Setting Professional Modifier None Typical Low $407.38 Median $407.38 Typical High $467.74 | Professional | None | $407.38 | $407.38 | $467.74 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $1,348.96 Typical High $2,344.23 | Facility | None | $645.65 | $1,348.96 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $407.38 | Professional | None | $363.08 | $363.08 | $407.38 |
Sanford Health Plan Setting Professional Modifier None Typical Low $257.04 Median $354.81 Typical High $457.09 | Professional | None | $257.04 | $354.81 | $457.09 |
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 $190.55 Median $478.63 Typical High $616.60 | Professional | None | $190.55 | $478.63 | $616.60 |
Wellmark Setting Professional Modifier None Typical Low $331.13 Median $407.38 Typical High $588.84 | Professional | None | $331.13 | $407.38 | $588.84 |
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 $79.43 Median $89.13 Typical High $114.82 | Professional | 52 · Reduced service | $79.43 | $89.13 | $114.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $36.31 Typical High $45.71 | Professional | 53 · Discontinued | $31.62 | $36.31 | $45.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $134.90 Typical High $173.78 | Professional | 54 · Surgery only | $120.23 | $134.90 | $173.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.99 Median $26.92 Typical High $34.67 | Professional | 55 · Aftercare only | $23.99 | $26.92 | $34.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $17.78 Typical High $22.91 | Professional | 56 · Pre-op care only | $15.85 | $17.78 | $22.91 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $125.89 Typical High $162.18 | Professional | 78 · Unplanned return to OR | $112.20 | $125.89 | $162.18 |
Where South Dakota sits
The same service costs 4.4 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
$407
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.