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 $114.82 Median $131.83 Typical High $4,365.16 | Facility | None | $114.82 | $131.83 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $134.90 Typical High $173.78 | Professional | None | $100.00 | $134.90 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $91.20 Median $117.49 Typical High $251.19 | Facility | None | $91.20 | $117.49 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $275.42 Typical High $346.74 | Professional | None | $223.87 | $275.42 | $346.74 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $165.96 Typical High $269.15 | Facility | None | $125.89 | $165.96 | $269.15 |
Medica Setting Professional Modifier None Typical Low $141.25 Median $316.23 Typical High $1,737.80 | Professional | None | $141.25 | $316.23 | $1,737.80 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $302.00 | Professional | None | $263.03 | $263.03 | $302.00 |
Midlands Setting Facility Modifier None Typical Low $91.20 Median $117.49 Typical High $138.04 | Facility | None | $91.20 | $117.49 | $138.04 |
Midlands Setting Professional Modifier None Typical Low $239.88 Median $257.04 Typical High $288.40 | Professional | None | $239.88 | $257.04 | $288.40 |
Sanford Health Plan Setting Professional Modifier None Typical Low $165.96 Median $204.17 Typical High $269.15 | Professional | None | $165.96 | $204.17 | $269.15 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $125.89 Median $257.04 Typical High $371.54 | Professional | None | $125.89 | $257.04 | $371.54 |
Wellmark Setting Professional Modifier None Typical Low $223.87 Median $263.03 Typical High $346.74 | Professional | None | $223.87 | $263.03 | $346.74 |
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 $48.98 Median $57.54 Typical High $67.61 | Professional | 52 · Reduced service | $48.98 | $57.54 | $67.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $22.91 Typical High $27.54 | Professional | 53 · Discontinued | $19.95 | $22.91 | $27.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $74.13 Median $87.10 Typical High $102.33 | Professional | 54 · Surgery only | $74.13 | $87.10 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $17.38 Typical High $20.42 | Professional | 55 · Aftercare only | $14.79 | $17.38 | $20.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $11.48 Typical High $13.49 | Professional | 56 · Pre-op care only | $10.00 | $11.48 | $13.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $69.18 Median $81.28 Typical High $95.50 | Professional | 78 · Unplanned return to OR | $69.18 | $81.28 | $95.50 |
Where South Dakota sits
The same service costs 4.2 times more in Alaska than in Florida. 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.