How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $1,148.15 Median $1,148.15 Typical High $4,365.16 | Facility | None | $1,148.15 | $1,148.15 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $1,230.27 Median $1,258.93 Typical High $1,318.26 | Professional | None | $1,230.27 | $1,258.93 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $1,698.24 Median $1,698.24 Typical High $2,137.96 | Facility | None | $1,698.24 | $1,698.24 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,288.25 Median $1,584.89 Typical High $1,819.70 | Professional | None | $1,288.25 | $1,584.89 | $1,819.70 |
Medica Setting Facility Modifier None Typical Low $758.58 Median $1,548.82 Typical High $2,137.96 | Facility | None | $758.58 | $1,548.82 | $2,137.96 |
Medica Setting Professional Modifier None Typical Low $1,348.96 Median $2,454.71 Typical High $7,762.47 | Professional | None | $1,348.96 | $2,454.71 | $7,762.47 |
Midlands Setting Professional Modifier None Typical Low $1,737.80 Median $1,819.70 Typical High $1,819.70 | Professional | None | $1,737.80 | $1,819.70 | $1,819.70 |
Midlands Setting Professional Modifier None Typical Low $2,344.23 Median $2,344.23 Typical High $2,344.23 | Professional | None | $2,344.23 | $2,344.23 | $2,344.23 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1,380.38 Median $1,819.70 Typical High $2,398.83 | Professional | None | $1,380.38 | $1,819.70 | $2,398.83 |
United Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $1,202.26 | Facility | None | $758.58 | $758.58 | $1,202.26 |
United Setting Professional Modifier None Typical Low $1,148.15 Median $2,454.71 Typical High $3,162.28 | Professional | None | $1,148.15 | $2,454.71 | $3,162.28 |
Wellmark Setting Professional Modifier None Typical Low $1,348.96 Median $1,659.59 Typical High $1,659.59 | Professional | None | $1,348.96 | $1,659.59 | $1,659.59 |
4 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 54 · Surgery only Typical Low $933.25 Median $933.25 Typical High $1,000.00 | Professional | 54 · Surgery only | $933.25 | $933.25 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $186.21 Typical High $199.53 | Professional | 55 · Aftercare only | $186.21 | $186.21 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $123.03 Median $125.89 Typical High $131.83 | Professional | 56 · Pre-op care only | $123.03 | $125.89 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $870.96 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $870.96 | $870.96 | $933.25 |
Where South Dakota sits
The same service costs 16.2 times more in Alaska than in Texas. 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· 13th of 51
$1,738
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.