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 $354.81 Median $398.11 Typical High $4,897.79 | Facility | None | $354.81 | $398.11 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $676.08 | Professional | None | $302.00 | $371.54 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $1,348.96 Typical High $2,137.96 | Facility | None | $602.56 | $1,348.96 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $741.31 Median $870.96 Typical High $1,202.26 | Professional | None | $741.31 | $870.96 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $467.74 Median $602.56 Typical High $1,698.24 | Facility | None | $467.74 | $602.56 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $380.19 Median $1,047.13 Typical High $3,162.28 | Professional | None | $380.19 | $1,047.13 | $3,162.28 |
Midlands Setting Professional Modifier None Typical Low $794.33 Median $870.96 Typical High $870.96 | Professional | None | $794.33 | $870.96 | $870.96 |
Midlands Setting Facility Modifier None Typical Low $1,348.96 Median $1,380.38 Typical High $2,344.23 | Facility | None | $1,348.96 | $1,380.38 | $2,344.23 |
Midlands Setting Professional Modifier None Typical Low $758.58 Median $758.58 Typical High $812.83 | Professional | None | $758.58 | $758.58 | $812.83 |
Sanford Health Plan Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $851.14 | Professional | None | $426.58 | $645.65 | $851.14 |
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 $380.19 Median $912.01 Typical High $1,096.48 | Professional | None | $380.19 | $912.01 | $1,096.48 |
Wellmark Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $1,047.13 | Professional | None | $691.83 | $851.14 | $1,047.13 |
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 $151.36 Median $177.83 Typical High $186.21 | Professional | 52 · Reduced service | $151.36 | $177.83 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $61.66 Median $70.79 Typical High $74.13 | Professional | 53 · Discontinued | $61.66 | $70.79 | $74.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $229.09 Median $263.03 Typical High $281.84 | Professional | 54 · Surgery only | $229.09 | $263.03 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $45.71 Median $52.48 Typical High $56.23 | Professional | 55 · Aftercare only | $45.71 | $52.48 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $30.20 Median $35.48 Typical High $37.15 | Professional | 56 · Pre-op care only | $30.20 | $35.48 | $37.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $213.80 Median $245.47 Typical High $263.03 | Professional | 78 · Unplanned return to OR | $213.80 | $245.47 | $263.03 |
Where South Dakota sits
The same service costs 4.3 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· 6th of 51
$813
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.