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 $3.47 Median $3.47 Typical High $3.47 | Facility | None | $3.47 | $3.47 | $3.47 |
Aetna Setting Professional Modifier None Typical Low $3.24 Median $3.24 Typical High $3.55 | Professional | None | $3.24 | $3.24 | $3.55 |
Cigna Setting Facility Modifier None Typical Low $7.59 Median $7.59 Typical High $9.33 | Facility | None | $7.59 | $7.59 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.62 Typical High $7.08 | Professional | None | $5.25 | $5.62 | $7.08 |
Medica Setting Facility Modifier None Typical Low $3.24 Median $5.50 Typical High $5.62 | Facility | None | $3.24 | $5.50 | $5.62 |
Medica Setting Professional Modifier None Typical Low $1.91 Median $2.40 Typical High $23.44 | Professional | None | $1.91 | $2.40 | $23.44 |
Midlands Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
Midlands Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $8.51 | Professional | None | $4.37 | $4.37 | $8.51 |
Sanford Health Plan Setting Professional Modifier None Typical Low $4.57 Median $4.79 Typical High $6.31 | Professional | None | $4.57 | $4.79 | $6.31 |
United Setting Professional Modifier None Typical Low $1.58 Median $1.91 Typical High $3.98 | Professional | None | $1.58 | $1.91 | $3.98 |
Wellmark Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | None | $3.89 | $3.89 | $3.89 |
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 $1.62 Median $1.62 Typical High $1.78 | Professional | 52 · Reduced service | $1.62 | $1.62 | $1.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.65 Median $0.65 Typical High $0.71 | Professional | 53 · Discontinued | $0.65 | $0.65 | $0.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.49 Median $0.49 Typical High $0.52 | Professional | 55 · Aftercare only | $0.49 | $0.49 | $0.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.33 Median $0.33 Typical High $0.35 | Professional | 56 · Pre-op care only | $0.33 | $0.33 | $0.35 |
Where South Dakota sits
The same service costs 2.6 times more in Hawaii than in Maine. 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· 13th of 51
$3.98
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.