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 $295.12 Median $295.12 Typical High $295.12 | Facility | None | $295.12 | $295.12 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $295.12 Median $316.23 Typical High $371.54 | Professional | None | $295.12 | $316.23 | $371.54 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $331.13 Typical High $407.38 | Professional | None | $173.78 | $331.13 | $407.38 |
Medica Setting Facility Modifier None Typical Low $407.38 Median $562.34 Typical High $562.34 | Facility | None | $407.38 | $562.34 | $562.34 |
Medica Setting Professional Modifier None Typical Low $173.78 Median $346.74 Typical High $1,258.93 | Professional | None | $173.78 | $346.74 | $1,258.93 |
Midlands Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $194.98 | Professional | None | $173.78 | $173.78 | $194.98 |
Midlands Setting Professional Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Professional | None | $281.84 | $281.84 | $281.84 |
United Setting Professional Modifier None Typical Low $309.03 Median $323.59 Typical High $371.54 | Professional | None | $309.03 | $323.59 | $371.54 |
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 $147.91 Median $158.49 Typical High $186.21 | Professional | 52 · Reduced service | $147.91 | $158.49 | $186.21 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $63.10 Typical High $74.13 | Professional | 53 · Discontinued | $58.88 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $47.86 Typical High $56.23 | Professional | 55 · Aftercare only | $44.67 | $47.86 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $31.62 Typical High $37.15 | Professional | 56 · Pre-op care only | $29.51 | $31.62 | $37.15 |
Where South Dakota sits
The same service costs 2.3 times more in Alaska than in Montana. 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· 39th of 51
$324
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.