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 $13.18 Median $13.18 Typical High $13.18 | Facility | None | $13.18 | $13.18 | $13.18 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $14.13 Typical High $15.85 | Professional | None | $12.88 | $14.13 | $15.85 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $20.89 Typical High $29.51 | Professional | None | $10.00 | $20.89 | $29.51 |
Medica Setting Facility Modifier None Typical Low $20.42 Median $23.99 Typical High $323.59 | Facility | None | $20.42 | $23.99 | $323.59 |
Medica Setting Professional Modifier None Typical Low $11.48 Median $13.49 Typical High $1,905.46 | Professional | None | $11.48 | $13.49 | $1,905.46 |
Midlands Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $26.30 | Professional | None | $24.55 | $24.55 | $26.30 |
Sanford Health Plan Setting Professional Modifier None Typical Low $16.22 Median $21.88 Typical High $43.65 | Professional | None | $16.22 | $21.88 | $43.65 |
United Setting Professional Modifier None Typical Low $11.22 Median $13.49 Typical High $24.55 | Professional | None | $11.22 | $13.49 | $24.55 |
Wellmark Setting Professional Modifier None Typical Low $26.30 Median $26.92 Typical High $31.62 | Professional | None | $26.30 | $26.92 | $31.62 |
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 $6.46 Median $7.08 Typical High $7.94 | Professional | 52 · Reduced service | $6.46 | $7.08 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.57 Median $2.82 Typical High $3.16 | Professional | 53 · Discontinued | $2.57 | $2.82 | $3.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.95 Median $2.14 Typical High $2.40 | Professional | 55 · Aftercare only | $1.95 | $2.14 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.29 Median $1.41 Typical High $1.58 | Professional | 56 · Pre-op care only | $1.29 | $1.41 | $1.58 |
Where South Dakota sits
The same service costs 43.7 times more in Hawaii than in Florida. 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· 9th of 51
$20.89
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.