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 $501.19 Median $524.81 Typical High $4,897.79 | Facility | None | $501.19 | $524.81 | $4,897.79 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $524.81 Typical High $660.69 | Professional | None | $436.52 | $524.81 | $660.69 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $407.38 Typical High $954.99 | Facility | None | $354.81 | $407.38 | $954.99 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,445.44 | Professional | None | $831.76 | $1,174.90 | $1,445.44 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $1,202.26 | Facility | None | $446.68 | $741.31 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $478.63 Median $1,096.48 Typical High $3,715.35 | Professional | None | $478.63 | $1,096.48 | $3,715.35 |
Midlands Setting Professional Modifier None Typical Low $1,148.15 Median $1,202.26 Typical High $1,202.26 | Professional | None | $1,148.15 | $1,202.26 | $1,202.26 |
Midlands Setting Facility Modifier None Typical Low $354.81 Median $398.11 Typical High $478.63 | Facility | None | $354.81 | $398.11 | $478.63 |
Sanford Health Plan Setting Professional Modifier None Typical Low $630.96 Median $851.14 Typical High $1,071.52 | Professional | None | $630.96 | $851.14 | $1,071.52 |
United Setting Facility Modifier None Typical Low $446.68 Median $537.03 Typical High $758.58 | Facility | None | $446.68 | $537.03 | $758.58 |
United Setting Professional Modifier None Typical Low $512.86 Median $1,023.29 Typical High $1,445.44 | Professional | None | $512.86 | $1,023.29 | $1,445.44 |
Wellmark Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,318.26 | Professional | None | $891.25 | $1,096.48 | $1,318.26 |
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 $218.78 Median $223.87 Typical High $275.42 | Professional | 52 · Reduced service | $218.78 | $223.87 | $275.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $89.13 Typical High $109.65 | Professional | 53 · Discontinued | $87.10 | $89.13 | $109.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $338.84 Typical High $407.38 | Professional | 54 · Surgery only | $323.59 | $338.84 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $67.61 Typical High $83.18 | Professional | 55 · Aftercare only | $64.57 | $67.61 | $83.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $44.67 Typical High $54.95 | Professional | 56 · Pre-op care only | $43.65 | $44.67 | $54.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $316.23 Typical High $380.19 | Professional | 78 · Unplanned return to OR | $302.00 | $316.23 | $380.19 |
Where South Dakota sits
The same service costs 6.2 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· 7th of 51
$933
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.