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 $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier None Typical Low $3,890.45 Median $4,073.80 Typical High $4,786.30 | Professional | None | $3,890.45 | $4,073.80 | $4,786.30 |
Cigna Setting Professional Modifier None Typical Low $5,011.87 Median $5,011.87 Typical High $6,309.57 | Professional | None | $5,011.87 | $5,011.87 | $6,309.57 |
Medica Setting Facility Modifier None Typical Low $6,165.95 Median $7,413.10 Typical High $7,413.10 | Facility | None | $6,165.95 | $7,413.10 | $7,413.10 |
Medica Setting Professional Modifier None Typical Low $5,623.41 Median $6,309.57 Typical High $6,309.57 | Professional | None | $5,623.41 | $6,309.57 | $6,309.57 |
Midlands Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,606.93 | $6,606.93 | $6,606.93 |
Midlands Setting Professional Modifier None Typical Low $6,606.93 Median $6,606.93 Typical High $6,606.93 | Professional | None | $6,606.93 | $6,606.93 | $6,606.93 |
United Setting Professional Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $6,309.57 | Professional | None | $5,623.41 | $5,623.41 | $6,309.57 |
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 $1,949.84 Median $2,041.74 Typical High $2,398.83 | Professional | 52 · Reduced service | $1,949.84 | $2,041.74 | $2,398.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $776.25 Median $812.83 Typical High $954.99 | Professional | 53 · Discontinued | $776.25 | $812.83 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $575.44 Median $616.60 Typical High $724.44 | Professional | 55 · Aftercare only | $575.44 | $616.60 | $724.44 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $389.05 Median $407.38 Typical High $478.63 | Professional | 56 · Pre-op care only | $389.05 | $407.38 | $478.63 |
Where South Dakota sits
The same service costs 1.5 times more in Alaska than in Idaho. 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· 11th of 51
$5,623
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.