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 $537.03 Typical High $4,365.16 | Facility | None | $501.19 | $537.03 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $436.52 Median $489.78 Typical High $954.99 | Professional | None | $436.52 | $489.78 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $371.54 Median $407.38 Typical High $977.24 | Facility | None | $371.54 | $407.38 | $977.24 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,230.27 Typical High $1,548.82 | Professional | None | $831.76 | $1,230.27 | $1,548.82 |
Medica Setting Facility Modifier None Typical Low $446.68 Median $741.31 Typical High $1,258.93 | Facility | None | $446.68 | $741.31 | $1,258.93 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,148.15 Typical High $3,890.45 | Professional | None | $489.78 | $1,148.15 | $3,890.45 |
Midlands Setting Professional Modifier None Typical Low $1,148.15 Median $1,230.27 Typical High $1,230.27 | Professional | None | $1,148.15 | $1,230.27 | $1,230.27 |
Midlands Setting Facility Modifier None Typical Low $371.54 Median $407.38 Typical High $489.78 | Facility | None | $371.54 | $407.38 | $489.78 |
Sanford Health Plan Setting Professional Modifier None Typical Low $660.69 Median $870.96 Typical High $1,288.25 | Professional | None | $660.69 | $870.96 | $1,288.25 |
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 $537.03 Median $1,071.52 Typical High $1,479.11 | Professional | None | $537.03 | $1,071.52 | $1,479.11 |
Wellmark Setting Professional Modifier None Typical Low $891.25 Median $1,096.48 Typical High $1,348.96 | Professional | None | $891.25 | $1,096.48 | $1,348.96 |
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 $234.42 Typical High $281.84 | Professional | 52 · Reduced service | $218.78 | $234.42 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $87.10 Median $93.33 Typical High $112.20 | Professional | 53 · Discontinued | $87.10 | $93.33 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $346.74 Typical High $426.58 | Professional | 54 · Surgery only | $323.59 | $346.74 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $69.18 Typical High $85.11 | Professional | 55 · Aftercare only | $64.57 | $69.18 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $43.65 Median $46.77 Typical High $56.23 | Professional | 56 · Pre-op care only | $43.65 | $46.77 | $56.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $302.00 Median $323.59 Typical High $398.11 | Professional | 78 · Unplanned return to OR | $302.00 | $323.59 | $398.11 |
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
$1,000
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.