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 $199.53 Median $309.03 Typical High $4,365.16 | Facility | None | $199.53 | $309.03 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $177.83 Median $281.84 Typical High $346.74 | Professional | None | $177.83 | $281.84 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $363.08 Typical High $575.44 | Facility | None | $288.40 | $363.08 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $588.84 Typical High $933.25 | Professional | None | $389.05 | $588.84 | $933.25 |
Medica Setting Facility Modifier None Typical Low $295.12 Median $478.63 Typical High $1,698.24 | Facility | None | $295.12 | $478.63 | $1,698.24 |
Medica Setting Professional Modifier None Typical Low $281.84 Median $616.60 Typical High $1,479.11 | Professional | None | $281.84 | $616.60 | $1,479.11 |
Midlands Setting Professional Modifier None Typical Low $457.09 Median $691.83 Typical High $691.83 | Professional | None | $457.09 | $691.83 | $691.83 |
Midlands Setting Facility Modifier None Typical Low $288.40 Median $338.84 Typical High $398.11 | Facility | None | $288.40 | $338.84 | $398.11 |
Sanford Health Plan Setting Professional Modifier None Typical Low $275.42 Median $436.52 Typical High $645.65 | Professional | None | $275.42 | $436.52 | $645.65 |
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 $239.88 Median $524.81 Typical High $870.96 | Professional | None | $239.88 | $524.81 | $870.96 |
Wellmark Setting Professional Modifier None Typical Low $371.54 Median $457.09 Typical High $812.83 | Professional | None | $371.54 | $457.09 | $812.83 |
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 $87.10 Median $141.25 Typical High $165.96 | Professional | 52 · Reduced service | $87.10 | $141.25 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $35.48 Median $56.23 Typical High $67.61 | Professional | 53 · Discontinued | $35.48 | $56.23 | $67.61 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $131.83 Median $208.93 Typical High $251.19 | Professional | 54 · Surgery only | $131.83 | $208.93 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $26.30 Median $41.69 Typical High $50.12 | Professional | 55 · Aftercare only | $26.30 | $41.69 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $17.78 Median $28.18 Typical High $33.88 | Professional | 56 · Pre-op care only | $17.78 | $28.18 | $33.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $123.03 Median $194.98 Typical High $234.42 | Professional | 78 · Unplanned return to OR | $123.03 | $194.98 | $234.42 |
Where South Dakota sits
The same service costs 4.3 times more in Wyoming 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· 8th of 51
$468
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.