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 $112.20 Median $173.78 Typical High $4,365.16 | Facility | None | $112.20 | $173.78 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $147.91 Typical High $190.55 | Professional | None | $97.72 | $147.91 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $1,047.13 Typical High $1,659.59 | Facility | None | $263.03 | $1,047.13 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $331.13 Typical High $489.78 | Professional | None | $204.17 | $331.13 | $489.78 |
Medica Setting Facility Modifier None Typical Low $147.91 Median $269.15 Typical High $1,202.26 | Facility | None | $147.91 | $269.15 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $151.36 Median $346.74 Typical High $831.76 | Professional | None | $151.36 | $346.74 | $831.76 |
Midlands Setting Professional Modifier None Typical Low $257.04 Median $389.05 Typical High $389.05 | Professional | None | $257.04 | $389.05 | $389.05 |
Midlands Setting Facility Modifier None Typical Low $645.65 Median $1,047.13 Typical High $1,698.24 | Facility | None | $645.65 | $1,047.13 | $1,698.24 |
Sanford Health Plan Setting Professional Modifier None Typical Low $151.36 Median $239.88 Typical High $354.81 | Professional | None | $151.36 | $239.88 | $354.81 |
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 $125.89 Median $295.12 Typical High $489.78 | Professional | None | $125.89 | $295.12 | $489.78 |
Wellmark Setting Professional Modifier None Typical Low $204.17 Median $251.19 Typical High $446.68 | Professional | None | $204.17 | $251.19 | $446.68 |
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 $79.43 Typical High $95.50 | Professional | 52 · Reduced service | $48.98 | $79.43 | $95.50 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $31.62 Typical High $38.02 | Professional | 53 · Discontinued | $19.50 | $31.62 | $38.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $117.49 Typical High $144.54 | Professional | 54 · Surgery only | $72.44 | $117.49 | $144.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $23.44 Typical High $28.84 | Professional | 55 · Aftercare only | $14.79 | $23.44 | $28.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $15.85 Typical High $19.05 | Professional | 56 · Pre-op care only | $9.77 | $15.85 | $19.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $67.61 Median $109.65 Typical High $134.90 | Professional | 78 · Unplanned return to OR | $67.61 | $109.65 | $134.90 |
Where South Dakota sits
The same service costs 4.8 times more in Alaska than in Kentucky. 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
$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.