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 $11.75 Median $11.75 Typical High $11.75 | Facility | None | $11.75 | $11.75 | $11.75 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $12.59 | Professional | None | $11.48 | $11.48 | $12.59 |
Cigna Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $25.70 | Professional | None | $19.95 | $19.95 | $25.70 |
Medica Setting Facility Modifier None Typical Low $14.79 Median $19.50 Typical High $19.50 | Facility | None | $14.79 | $19.50 | $19.50 |
Medica Setting Professional Modifier None Typical Low $13.18 Median $25.12 Typical High $70.79 | Professional | None | $13.18 | $25.12 | $70.79 |
Midlands Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $26.30 | Professional | None | $23.44 | $23.44 | $26.30 |
Sanford Health Plan Setting Professional Modifier None Typical Low $13.18 Median $13.80 Typical High $20.89 | Professional | None | $13.18 | $13.80 | $20.89 |
United Setting Professional Modifier None Typical Low $13.18 Median $20.89 Typical High $25.12 | Professional | None | $13.18 | $20.89 | $25.12 |
Wellmark Setting Professional Modifier None Typical Low $23.44 Median $28.84 Typical High $28.84 | Professional | None | $23.44 | $28.84 | $28.84 |
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 $5.75 Median $5.75 Typical High $5.75 | Professional | 52 · Reduced service | $5.75 | $5.75 | $5.75 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $2.29 | Professional | 53 · Discontinued | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $1.74 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $1.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.15 Typical High $1.15 | Professional | 56 · Pre-op care only | $1.15 | $1.15 | $1.15 |
Where South Dakota sits
The same service costs 2.6 times more in Alaska than in Kentucky. 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· 7th of 51
$19.95
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.