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 $144.54 Median $338.84 Typical High $2,290.87 | Facility | None | $144.54 | $338.84 | $2,290.87 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $123.03 Typical High $177.83 | Professional | None | $95.50 | $123.03 | $177.83 |
Cigna Setting Facility Modifier None Typical Low $74.13 Median $102.33 Typical High $263.03 | Facility | None | $74.13 | $102.33 | $263.03 |
Cigna Setting Professional Modifier None Typical Low $229.09 Median $275.42 Typical High $371.54 | Professional | None | $229.09 | $275.42 | $371.54 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $162.18 Typical High $338.84 | Facility | None | $125.89 | $162.18 | $338.84 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $338.84 Typical High $1,096.48 | Professional | None | $151.36 | $338.84 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $323.59 | Professional | None | $269.15 | $269.15 | $323.59 |
Midlands Setting Facility Modifier None Typical Low $74.13 Median $97.72 Typical High $123.03 | Facility | None | $74.13 | $97.72 | $123.03 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $263.03 Typical High $309.03 | Professional | None | $257.04 | $263.03 | $309.03 |
Sanford Health Plan Setting Professional Modifier None Typical Low $177.83 Median $234.42 Typical High $295.12 | Professional | None | $177.83 | $234.42 | $295.12 |
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 $131.83 Median $269.15 Typical High $398.11 | Professional | None | $131.83 | $269.15 | $398.11 |
Wellmark Setting Professional Modifier None Typical Low $229.09 Median $269.15 Typical High $380.19 | Professional | None | $229.09 | $269.15 | $380.19 |
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 $47.86 Median $61.66 Typical High $70.79 | Professional | 52 · Reduced service | $47.86 | $61.66 | $70.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $24.55 Typical High $28.84 | Professional | 53 · Discontinued | $19.05 | $24.55 | $28.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $93.33 Typical High $107.15 | Professional | 54 · Surgery only | $72.44 | $93.33 | $107.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $18.62 Typical High $21.38 | Professional | 55 · Aftercare only | $14.45 | $18.62 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.30 Typical High $14.45 | Professional | 56 · Pre-op care only | $9.55 | $12.30 | $14.45 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $87.10 Typical High $100.00 | Professional | 78 · Unplanned return to OR | $67.61 | $87.10 | $100.00 |
Where South Dakota sits
The same service costs 3.9 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
$269
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.