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 $436.52 Median $549.54 Typical High $4,365.16 | Facility | None | $436.52 | $549.54 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $380.19 Median $478.63 Typical High $588.84 | Professional | None | $380.19 | $478.63 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $812.83 Median $1,258.93 Typical High $1,348.96 | Facility | None | $812.83 | $1,258.93 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $724.44 Median $1,258.93 Typical High $1,621.81 | Professional | None | $724.44 | $1,258.93 | $1,621.81 |
Medica Setting Facility Modifier None Typical Low $645.65 Median $812.83 Typical High $1,698.24 | Facility | None | $645.65 | $812.83 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $489.78 Median $1,122.02 Typical High $3,630.78 | Professional | None | $489.78 | $1,122.02 | $3,630.78 |
Midlands Setting Professional Modifier None Typical Low $1,023.29 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,023.29 | $1,258.93 | $1,258.93 |
Midlands Setting Facility Modifier None Typical Low $1,202.26 Median $1,288.25 Typical High $1,479.11 | Facility | None | $1,202.26 | $1,288.25 | $1,479.11 |
Sanford Health Plan Setting Professional Modifier None Typical Low $602.56 Median $851.14 Typical High $1,096.48 | Professional | None | $602.56 | $851.14 | $1,096.48 |
United Setting Facility Modifier None Typical Low $1,513.56 Median $1,513.56 Typical High $1,819.70 | Facility | None | $1,513.56 | $1,513.56 | $1,819.70 |
United Setting Professional Modifier None Typical Low $478.63 Median $977.24 Typical High $1,513.56 | Professional | None | $478.63 | $977.24 | $1,513.56 |
Wellmark Setting Professional Modifier None Typical Low $794.33 Median $977.24 Typical High $1,412.54 | Professional | None | $794.33 | $977.24 | $1,412.54 |
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 $190.55 Median $239.88 Typical High $295.12 | Professional | 52 · Reduced service | $190.55 | $239.88 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $95.50 Typical High $117.49 | Professional | 53 · Discontinued | $75.86 | $95.50 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $363.08 Typical High $436.52 | Professional | 54 · Surgery only | $288.40 | $363.08 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $72.44 Typical High $87.10 | Professional | 55 · Aftercare only | $57.54 | $72.44 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $47.86 Typical High $58.88 | Professional | 56 · Pre-op care only | $38.02 | $47.86 | $58.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $338.84 Typical High $407.38 | Professional | 78 · Unplanned return to OR | $269.15 | $338.84 | $407.38 |
Where South Dakota sits
The same service costs 6.5 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· 6th 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.