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 $40.74 Median $40.74 Typical High $40.74 | Facility | None | $40.74 | $40.74 | $40.74 |
Aetna Setting Professional Modifier None Typical Low $40.74 Median $43.65 Typical High $51.29 | Professional | None | $40.74 | $43.65 | $51.29 |
Cigna Setting Professional Modifier None Typical Low $41.69 Median $46.77 Typical High $52.48 | Professional | None | $41.69 | $46.77 | $52.48 |
Medica Setting Facility Modifier None Typical Low $58.88 Median $77.62 Typical High $77.62 | Facility | None | $58.88 | $77.62 | $77.62 |
Medica Setting Professional Modifier None Typical Low $40.74 Median $44.67 Typical High $229.09 | Professional | None | $40.74 | $44.67 | $229.09 |
Midlands Setting Professional Modifier None Typical Low $46.77 Median $46.77 Typical High $52.48 | Professional | None | $46.77 | $46.77 | $52.48 |
Midlands Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
United Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $47.86 | Professional | None | $40.74 | $40.74 | $47.86 |
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 $20.42 Median $21.88 Typical High $25.70 | Professional | 52 · Reduced service | $20.42 | $21.88 | $25.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.71 Typical High $10.23 | Professional | 53 · Discontinued | $8.13 | $8.71 | $10.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.46 Typical High $7.59 | Professional | 55 · Aftercare only | $6.17 | $6.46 | $7.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.37 Typical High $5.13 | Professional | 56 · Pre-op care only | $4.07 | $4.37 | $5.13 |
Where South Dakota sits
The same service costs 2.0 times more in Alaska than in New Mexico. 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
$44.67
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.