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 $4.57 Median $4.57 Typical High $4.90 | Facility | None | $4.57 | $4.57 | $4.90 |
Aetna Setting Professional Modifier None Typical Low $4.57 Median $4.57 Typical High $5.13 | Professional | None | $4.57 | $4.57 | $5.13 |
Cigna Setting Professional Modifier None Typical Low $7.76 Median $8.13 Typical High $9.77 | Professional | None | $7.76 | $8.13 | $9.77 |
Medica Setting Facility Modifier None Typical Low $6.03 Median $7.76 Typical High $11.48 | Facility | None | $6.03 | $7.76 | $11.48 |
Medica Setting Professional Modifier None Typical Low $9.55 Median $29.51 Typical High $29.51 | Professional | None | $9.55 | $29.51 | $29.51 |
Midlands Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
Midlands Setting Professional Modifier None Typical Low $8.91 Median $8.91 Typical High $9.12 | Professional | None | $8.91 | $8.91 | $9.12 |
Sanford Health Plan Setting Professional Modifier None Typical Low $5.37 Median $6.03 Typical High $8.13 | Professional | None | $5.37 | $6.03 | $8.13 |
United Setting Professional Modifier None Typical Low $4.68 Median $9.33 Typical High $13.80 | Professional | None | $4.68 | $9.33 | $13.80 |
Wellmark Setting Professional Modifier None Typical Low $7.76 Median $9.55 Typical High $9.55 | Professional | None | $7.76 | $9.55 | $9.55 |
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 $2.29 Median $2.29 Typical High $2.29 | Professional | 52 · Reduced service | $2.29 | $2.29 | $2.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.91 Median $0.91 Typical High $0.91 | Professional | 53 · Discontinued | $0.91 | $0.91 | $0.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.69 Median $0.69 Typical High $0.69 | Professional | 55 · Aftercare only | $0.69 | $0.69 | $0.69 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | 56 · Pre-op care only | $0.46 | $0.46 | $0.46 |
Where South Dakota sits
The same service costs 2.7 times more in North Dakota than in New Mexico. 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· 6th of 51
$7.76
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.