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 $138.04 Median $275.42 Typical High $4,365.16 | Facility | None | $138.04 | $275.42 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $120.23 Median $213.80 Typical High $288.40 | Professional | None | $120.23 | $213.80 | $288.40 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $575.44 Typical High $741.31 | Facility | None | $398.11 | $575.44 | $741.31 |
Cigna Setting Professional Modifier None Typical Low $263.03 Median $407.38 Typical High $794.33 | Professional | None | $263.03 | $407.38 | $794.33 |
Medica Setting Facility Modifier None Typical Low $204.17 Median $407.38 Typical High $1,202.26 | Facility | None | $204.17 | $407.38 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $245.47 Median $562.34 Typical High $1,023.29 | Professional | None | $245.47 | $562.34 | $1,023.29 |
Midlands Setting Professional Modifier None Typical Low $316.23 Median $616.60 Typical High $616.60 | Professional | None | $316.23 | $616.60 | $616.60 |
Midlands Setting Facility Modifier None Typical Low $575.44 Median $676.08 Typical High $954.99 | Facility | None | $575.44 | $676.08 | $954.99 |
Sanford Health Plan Setting Professional Modifier None Typical Low $218.78 Median $363.08 Typical High $537.03 | Professional | None | $218.78 | $363.08 | $537.03 |
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 $158.49 Median $371.54 Typical High $758.58 | Professional | None | $158.49 | $371.54 | $758.58 |
Wellmark Setting Professional Modifier None Typical Low $251.19 Median $302.00 Typical High $691.83 | Professional | None | $251.19 | $302.00 | $691.83 |
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 $60.26 Median $120.23 Typical High $144.54 | Professional | 52 · Reduced service | $60.26 | $120.23 | $144.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.99 Median $47.86 Typical High $57.54 | Professional | 53 · Discontinued | $23.99 | $47.86 | $57.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $89.13 Median $177.83 Typical High $213.80 | Professional | 54 · Surgery only | $89.13 | $177.83 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.78 Median $35.48 Typical High $43.65 | Professional | 55 · Aftercare only | $17.78 | $35.48 | $43.65 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.02 Median $23.99 Typical High $28.84 | Professional | 56 · Pre-op care only | $12.02 | $23.99 | $28.84 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $83.18 Median $165.96 Typical High $199.53 | Professional | 78 · Unplanned return to OR | $83.18 | $165.96 | $199.53 |
Where South Dakota sits
The same service costs 4.7 times more in Alaska than in Virginia. 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
$380
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.