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 $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $54.95 Median $61.66 Typical High $61.66 | Professional | None | $54.95 | $61.66 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | None | $85.11 | $87.10 | $87.10 |
Medica Setting Facility Modifier None Typical Low $87.10 Median $104.71 Typical High $128.82 | Facility | None | $87.10 | $104.71 | $128.82 |
Medica Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $371.54 | Professional | None | $60.26 | $60.26 | $371.54 |
Midlands Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $93.33 | Professional | None | $87.10 | $87.10 | $93.33 |
United Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $67.61 | Professional | None | $61.66 | $61.66 | $67.61 |
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 $27.54 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $27.54 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.96 Median $12.30 Typical High $12.30 | Professional | 53 · Discontinued | $10.96 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.13 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.13 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.50 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.50 | $6.17 | $6.17 |
Where South Dakota sits
The same service costs 4.6 times more in New York than in North Carolina. 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· 12th of 51
$66.07
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.