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 $46.77 Median $46.77 Typical High $46.77 | Facility | None | $46.77 | $46.77 | $46.77 |
Aetna Setting Professional Modifier None Typical Low $46.77 Median $50.12 Typical High $58.88 | Professional | None | $46.77 | $50.12 | $58.88 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $66.07 | Professional | None | $52.48 | $52.48 | $66.07 |
Medica Setting Facility Modifier None Typical Low $67.61 Median $89.13 Typical High $89.13 | Facility | None | $67.61 | $89.13 | $89.13 |
Medica Setting Professional Modifier None Typical Low $58.88 Median $66.07 Typical High $66.07 | Professional | None | $58.88 | $66.07 | $66.07 |
Midlands Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
Midlands Setting Professional Modifier None Typical Low $63.10 Median $63.10 Typical High $63.10 | Professional | None | $63.10 | $63.10 | $63.10 |
United Setting Professional Modifier None Typical Low $58.88 Median $58.88 Typical High $66.07 | Professional | None | $58.88 | $58.88 | $66.07 |
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 $23.44 Median $25.12 Typical High $29.51 | Professional | 52 · Reduced service | $23.44 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.33 Median $10.00 Typical High $11.75 | Professional | 53 · Discontinued | $9.33 | $10.00 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.08 Median $7.59 Typical High $8.91 | Professional | 55 · Aftercare only | $7.08 | $7.59 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.68 Median $5.01 Typical High $5.89 | Professional | 56 · Pre-op care only | $4.68 | $5.01 | $5.89 |
Where South Dakota sits
The same service costs 1.6 times more in Alaska than in Pennsylvania. 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
$58.88
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.