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 $1.45 Median $1.45 Typical High $1.45 | Facility | None | $1.45 | $1.45 | $1.45 |
Aetna Setting Professional Modifier None Typical Low $1.29 Median $1.35 Typical High $1.35 | Professional | None | $1.29 | $1.35 | $1.35 |
Cigna Setting Facility Modifier None Typical Low $2.51 Median $2.51 Typical High $3.16 | Facility | None | $2.51 | $2.51 | $3.16 |
Cigna Setting Professional Modifier None Typical Low $1.86 Median $2.19 Typical High $2.51 | Professional | None | $1.86 | $2.19 | $2.51 |
Medica Setting Facility Modifier None Typical Low $1.38 Median $2.29 Typical High $2.34 | Facility | None | $1.38 | $2.29 | $2.34 |
Medica Setting Professional Modifier None Typical Low $0.71 Median $1.00 Typical High $10.00 | Professional | None | $0.71 | $1.00 | $10.00 |
Midlands Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
Midlands Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $3.55 | Professional | None | $1.82 | $1.82 | $3.55 |
Sanford Health Plan Setting Professional Modifier None Typical Low $1.91 Median $2.00 Typical High $2.63 | Professional | None | $1.91 | $2.00 | $2.63 |
United Setting Professional Modifier None Typical Low $0.66 Median $0.79 Typical High $1.66 | Professional | None | $0.66 | $0.79 | $1.66 |
Wellmark Setting Professional Modifier None Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | None | $1.62 | $1.62 | $1.62 |
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 $0.20 Median $0.20 Typical High $0.22 | Professional | 55 · Aftercare only | $0.20 | $0.20 | $0.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.13 Median $0.14 Typical High $0.14 | Professional | 56 · Pre-op care only | $0.13 | $0.14 | $0.14 |
Where South Dakota sits
The same service costs 3.1 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· 13th of 51
$1.66
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.