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 $1.23 Median $1.23 Typical High $1.23 | Facility | None | $1.23 | $1.23 | $1.23 |
Aetna Setting Professional Modifier None Typical Low $1.00 Median $1.00 Typical High $3.72 | Professional | None | $1.00 | $1.00 | $3.72 |
Cigna Setting Facility Modifier None Typical Low $2.00 Median $2.00 Typical High $2.51 | Facility | None | $2.00 | $2.00 | $2.51 |
Cigna Setting Professional Modifier None Typical Low $1.51 Median $1.62 Typical High $2.19 | Professional | None | $1.51 | $1.62 | $2.19 |
Medica Setting Facility Modifier None Typical Low $1.66 Median $1.66 Typical High $11.48 | Facility | None | $1.66 | $1.66 | $11.48 |
Medica Setting Professional Modifier None Typical Low $0.71 Median $0.85 Typical High $51.29 | Professional | None | $0.71 | $0.85 | $51.29 |
Midlands Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | None | $1.62 | $1.62 | $1.62 |
Midlands Setting Professional Modifier None Typical Low $3.16 Median $3.16 Typical High $3.16 | Professional | None | $3.16 | $3.16 | $3.16 |
Sanford Health Plan Setting Professional Modifier None Typical Low $0.95 Median $1.41 Typical High $1.74 | Professional | None | $0.95 | $1.41 | $1.74 |
United Setting Professional Modifier None Typical Low $0.56 Median $0.71 Typical High $1.41 | Professional | None | $0.56 | $0.71 | $1.41 |
Wellmark Setting Professional Modifier None Typical Low $1.38 Median $1.38 Typical High $1.38 | Professional | None | $1.38 | $1.38 | $1.38 |
2 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 55 · Aftercare only Typical Low $0.15 Median $0.15 Typical High $0.16 | Professional | 55 · Aftercare only | $0.15 | $0.15 | $0.16 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.10 Median $0.10 Typical High $0.11 | Professional | 56 · Pre-op care only | $0.10 | $0.10 | $0.11 |
Where South Dakota sits
The same service costs 7.4 times more in Kentucky than in Delaware. 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· 26th of 51
$1.41
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.