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 $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $2.63 Median $5.13 Typical High $5.50 | Professional | None | $2.63 | $5.13 | $5.50 |
Cigna Setting Facility Modifier None Typical Low $11.48 Median $11.48 Typical High $14.45 | Facility | None | $11.48 | $11.48 | $14.45 |
Cigna Setting Professional Modifier None Typical Low $7.94 Median $8.71 Typical High $10.72 | Professional | None | $7.94 | $8.71 | $10.72 |
Medica Setting Facility Modifier None Typical Low $4.57 Median $8.71 Typical High $8.71 | Facility | None | $4.57 | $8.71 | $8.71 |
Medica Setting Professional Modifier None Typical Low $2.95 Median $3.72 Typical High $37.15 | Professional | None | $2.95 | $3.72 | $37.15 |
Midlands Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $7.94 | Professional | None | $7.94 | $7.94 | $7.94 |
Midlands Setting Professional Modifier None Typical Low $6.03 Median $6.03 Typical High $13.49 | Professional | None | $6.03 | $6.03 | $13.49 |
Sanford Health Plan Setting Professional Modifier None Typical Low $7.08 Median $7.41 Typical High $9.77 | Professional | None | $7.08 | $7.41 | $9.77 |
United Setting Professional Modifier None Typical Low $2.45 Median $2.95 Typical High $6.17 | Professional | None | $2.45 | $2.95 | $6.17 |
Wellmark Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $5.37 | Professional | None | $5.37 | $5.37 | $5.37 |
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 $0.78 Median $0.78 Typical High $0.83 | Professional | 55 · Aftercare only | $0.78 | $0.78 | $0.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.51 Median $0.51 Typical High $0.55 | Professional | 56 · Pre-op care only | $0.51 | $0.51 | $0.55 |
Where South Dakota sits
The same service costs 2.5 times more in Idaho than in Colorado. 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
$6.17
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.