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 $151.36 Median $173.78 Typical High $4,365.16 | Facility | None | $151.36 | $173.78 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $190.55 | Professional | None | $134.90 | $162.18 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $457.09 Typical High $891.25 | Facility | None | $275.42 | $457.09 | $891.25 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $389.05 Typical High $549.54 | Professional | None | $331.13 | $389.05 | $549.54 |
Medica Setting Facility Modifier None Typical Low $208.93 Median $269.15 Typical High $1,202.26 | Facility | None | $208.93 | $269.15 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $467.74 Typical High $1,380.38 | Professional | None | $151.36 | $467.74 | $1,380.38 |
Midlands Setting Professional Modifier None Typical Low $346.74 Median $354.81 Typical High $389.05 | Professional | None | $346.74 | $354.81 | $389.05 |
Midlands Setting Facility Modifier None Typical Low $457.09 Median $645.65 Typical High $891.25 | Facility | None | $457.09 | $645.65 | $891.25 |
Midlands Setting Professional Modifier None Typical Low $302.00 Median $302.00 Typical High $338.84 | Professional | None | $302.00 | $302.00 | $338.84 |
Sanford Health Plan Setting Professional Modifier None Typical Low $186.21 Median $275.42 Typical High $346.74 | Professional | None | $186.21 | $275.42 | $346.74 |
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 $151.36 Median $398.11 Typical High $489.78 | Professional | None | $151.36 | $398.11 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $288.40 Median $354.81 Typical High $457.09 | Professional | None | $288.40 | $354.81 | $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 $67.61 Median $81.28 Typical High $95.50 | Professional | 52 · Reduced service | $67.61 | $81.28 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $32.36 Typical High $38.02 | Professional | 53 · Discontinued | $26.92 | $32.36 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $102.33 Median $120.23 Typical High $141.25 | Professional | 54 · Surgery only | $102.33 | $120.23 | $141.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.42 Median $23.99 Typical High $28.84 | Professional | 55 · Aftercare only | $20.42 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.22 Typical High $19.05 | Professional | 56 · Pre-op care only | $13.49 | $16.22 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $95.50 Median $112.20 Typical High $131.83 | Professional | 78 · Unplanned return to OR | $95.50 | $112.20 | $131.83 |
Where South Dakota sits
The same service costs 4.6 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
$355
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.