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 $2.45 Median $2.45 Typical High $2.45 | Facility | None | $2.45 | $2.45 | $2.45 |
Aetna Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $2.51 | Professional | None | $2.40 | $2.40 | $2.51 |
Cigna Setting Facility Modifier None Typical Low $5.01 Median $5.01 Typical High $6.31 | Facility | None | $5.01 | $5.01 | $6.31 |
Cigna Setting Professional Modifier None Typical Low $3.72 Median $3.80 Typical High $4.68 | Professional | None | $3.72 | $3.80 | $4.68 |
Medica Setting Facility Modifier None Typical Low $4.07 Median $4.07 Typical High $4.17 | Facility | None | $4.07 | $4.07 | $4.17 |
Medica Setting Professional Modifier None Typical Low $1.29 Median $1.70 Typical High $16.98 | Professional | None | $1.29 | $1.70 | $16.98 |
Midlands Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $3.80 | Professional | None | $3.80 | $3.80 | $3.80 |
Midlands Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $5.89 | Professional | None | $3.16 | $3.16 | $5.89 |
Sanford Health Plan Setting Professional Modifier None Typical Low $3.09 Median $3.39 Typical High $3.89 | Professional | None | $3.09 | $3.39 | $3.89 |
United Setting Professional Modifier None Typical Low $1.29 Median $1.41 Typical High $2.82 | Professional | None | $1.29 | $1.41 | $2.82 |
Wellmark Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
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 $1.20 Median $1.20 Typical High $1.26 | Professional | 52 · Reduced service | $1.20 | $1.20 | $1.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.48 Median $0.48 Typical High $0.50 | Professional | 53 · Discontinued | $0.48 | $0.48 | $0.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.36 Median $0.36 Typical High $0.38 | Professional | 55 · Aftercare only | $0.36 | $0.36 | $0.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.24 Median $0.24 Typical High $0.25 | Professional | 56 · Pre-op care only | $0.24 | $0.24 | $0.25 |
Where South Dakota sits
The same service costs 2.3 times more in Hawaii 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· 12th of 51
$3.02
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.