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 $575,439.94 Median $575,439.94 Typical High $676,082.98 | Facility | None | $575,439.94 | $575,439.94 | $676,082.98 |
Aetna Setting Professional Modifier None Typical Low $575,439.94 Median $575,439.94 Typical High $676,082.98 | Professional | None | $575,439.94 | $575,439.94 | $676,082.98 |
Cigna Setting Professional Modifier None Typical Low $549,540.87 Median $549,540.87 Typical High $676,082.98 | Professional | None | $549,540.87 | $549,540.87 | $676,082.98 |
Medica Setting Facility Modifier None Typical Low $741,310.24 Median $870,963.59 Typical High $870,963.59 | Facility | None | $741,310.24 | $870,963.59 | $870,963.59 |
Medica Setting Professional Modifier None Typical Low $562,341.33 Median $977,237.22 Typical High $977,237.22 | Professional | None | $562,341.33 | $977,237.22 | $977,237.22 |
Midlands Setting Professional Modifier None Typical Low $562,341.33 Median $562,341.33 Typical High $588,843.66 | Professional | None | $562,341.33 | $562,341.33 | $588,843.66 |
Sanford Health Plan Setting Professional Modifier None Typical Low $630,957.34 Median $630,957.34 Typical High $630,957.34 | Professional | None | $630,957.34 | $630,957.34 | $630,957.34 |
United Setting Professional Modifier None Typical Low $562,341.33 Median $758,577.58 Typical High $851,138.04 | Professional | None | $562,341.33 | $758,577.58 | $851,138.04 |
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 52 · Reduced service Typical Low $288,403.15 Median $288,403.15 Typical High $331,131.12 | Professional | 52 · Reduced service | $288,403.15 | $288,403.15 | $331,131.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114,815.36 Median $114,815.36 Typical High $134,896.29 | Professional | 53 · Discontinued | $114,815.36 | $114,815.36 | $134,896.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87,096.36 Median $87,096.36 Typical High $100,000.00 | Professional | 55 · Aftercare only | $87,096.36 | $87,096.36 | $100,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57,543.99 Median $57,543.99 Typical High $67,608.30 | Professional | 56 · Pre-op care only | $57,543.99 | $57,543.99 | $67,608.30 |
Where South Dakota sits
The same service costs 1.7 times more in Texas than in Minnesota. 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· 26th of 51
$575,440
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.