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 $3.09 Median $3.09 Typical High $3.09 | Facility | None | $3.09 | $3.09 | $3.09 |
Aetna Setting Professional Modifier None Typical Low $2.45 Median $3.02 Typical High $3.24 | Professional | None | $2.45 | $3.02 | $3.24 |
Aetna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $1.20 Median $1.20 Typical High $1.20 | Professional | AU · Urologic/ostomy supply | $1.20 | $1.20 | $1.20 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $8.71 | Facility | None | $7.08 | $7.08 | $8.71 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.61 | Professional | None | $5.25 | $5.25 | $6.61 |
Cigna Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $4.17 Median $4.17 Typical High $5.62 | Professional | AU · Urologic/ostomy supply | $4.17 | $4.17 | $5.62 |
Medica Setting Facility Modifier None Typical Low $3.02 Median $5.13 Typical High $5.25 | Facility | None | $3.02 | $5.13 | $5.25 |
Medica Setting Professional Modifier None Typical Low $1.70 Median $2.19 Typical High $21.88 | Professional | None | $1.70 | $2.19 | $21.88 |
Midlands Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $4.17 Median $4.17 Typical High $4.17 | Professional | AU · Urologic/ostomy supply | $4.17 | $4.17 | $4.17 |
Midlands Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $3.98 Median $3.98 Typical High $7.76 | Professional | AU · Urologic/ostomy supply | $3.98 | $3.98 | $7.76 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1.74 Median $4.37 Typical High $5.13 | Professional | None | $1.74 | $4.37 | $5.13 |
United Setting Professional Modifier None Typical Low $1.45 Median $1.74 Typical High $3.63 | Professional | None | $1.45 | $1.74 | $3.63 |
Wellmark Setting Professional Modifier None Typical Low $3.55 Median $3.55 Typical High $3.55 | Professional | None | $3.55 | $3.55 | $3.55 |
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 $1.51 Median $1.51 Typical High $1.62 | Professional | 52 · Reduced service | $1.51 | $1.51 | $1.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.60 Median $0.60 Typical High $0.65 | Professional | 53 · Discontinued | $0.60 | $0.60 | $0.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.45 Median $0.45 Typical High $0.49 | Professional | 55 · Aftercare only | $0.45 | $0.45 | $0.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.30 Median $0.30 Typical High $0.32 | Professional | 56 · Pre-op care only | $0.30 | $0.30 | $0.32 |
Where South Dakota sits
The same service costs 4.4 times more in Minnesota than in New Hampshire. 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· 11th of 51
$3.55
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.