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 $7.76 Median $7.76 Typical High $7.76 | Facility | None | $7.76 | $7.76 | $7.76 |
Aetna Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $7.94 | Professional | None | $7.41 | $7.41 | $7.94 |
Cigna Setting Facility Modifier None Typical Low $16.60 Median $16.60 Typical High $20.42 | Facility | None | $16.60 | $16.60 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $10.96 Median $12.30 Typical High $15.49 | Professional | None | $10.96 | $12.30 | $15.49 |
Medica Setting Facility Modifier None Typical Low $7.41 Median $12.59 Typical High $12.59 | Facility | None | $7.41 | $12.59 | $12.59 |
Medica Setting Professional Modifier None Typical Low $4.27 Median $5.37 Typical High $57.54 | Professional | None | $4.27 | $5.37 | $57.54 |
Midlands Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
Midlands Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $19.50 | Professional | None | $9.77 | $9.77 | $19.50 |
Sanford Health Plan Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $13.49 | Professional | None | $10.72 | $10.72 | $13.49 |
United Setting Professional Modifier None Typical Low $3.55 Median $4.27 Typical High $8.91 | Professional | None | $3.55 | $4.27 | $8.91 |
Wellmark Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $8.71 | Professional | None | $8.71 | $8.71 | $8.71 |
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 $1.12 Median $1.12 Typical High $1.20 | Professional | 55 · Aftercare only | $1.12 | $1.12 | $1.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.74 Median $0.74 Typical High $0.79 | Professional | 56 · Pre-op care only | $0.74 | $0.74 | $0.79 |
Where South Dakota sits
The same service costs 3.3 times more in Hawaii than in Utah. 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· 10th of 51
$9.55
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.