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 $199.53 Median $2,290.87 Typical High $4,365.16 | Facility | None | $199.53 | $2,290.87 | $4,365.16 |
Aetna Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $295.12 | Professional | None | $288.40 | $288.40 | $295.12 |
Cigna Setting Facility Modifier None Typical Low $831.76 Median $831.76 Typical High $1,202.26 | Facility | None | $831.76 | $831.76 | $1,202.26 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $758.58 Typical High $1,202.26 | Facility | None | $407.38 | $758.58 | $1,202.26 |
Medica Setting Professional Modifier None Typical Low $338.84 Median $588.84 Typical High $2,238.72 | Professional | None | $338.84 | $588.84 | $2,238.72 |
Midlands Setting Professional Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Professional | None | $380.19 | $380.19 | $380.19 |
Midlands Setting Facility Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,445.44 | Facility | None | $831.76 | $1,202.26 | $1,445.44 |
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 $323.59 Median $588.84 Typical High $831.76 | Professional | None | $323.59 | $588.84 | $831.76 |
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 $144.54 Median $144.54 Typical High $147.91 | Professional | 52 · Reduced service | $144.54 | $144.54 | $147.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $57.54 Typical High $60.26 | Professional | 53 · Discontinued | $57.54 | $57.54 | $60.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $42.66 Median $42.66 Typical High $44.67 | Professional | 55 · Aftercare only | $42.66 | $42.66 | $44.67 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $28.84 Typical High $29.51 | Professional | 56 · Pre-op care only | $28.84 | $28.84 | $29.51 |
Where South Dakota sits
The same service costs 7.1 times more in Alaska than in Kentucky. 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· 5th of 51
$589
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.