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 $1.91 Median $1.91 Typical High $1.91 | Facility | None | $1.91 | $1.91 | $1.91 |
Aetna Setting Professional Modifier None Typical Low $1.78 Median $1.78 Typical High $1.95 | Professional | None | $1.78 | $1.78 | $1.95 |
Cigna Setting Facility Modifier None Typical Low $3.98 Median $3.98 Typical High $5.01 | Facility | None | $3.98 | $3.98 | $5.01 |
Cigna Setting Professional Modifier None Typical Low $2.88 Median $3.02 Typical High $3.72 | Professional | None | $2.88 | $3.02 | $3.72 |
Medica Setting Facility Modifier None Typical Low $1.78 Median $3.02 Typical High $3.09 | Facility | None | $1.78 | $3.02 | $3.09 |
Medica Setting Professional Modifier None Typical Low $1.05 Median $1.32 Typical High $12.88 | Professional | None | $1.05 | $1.32 | $12.88 |
Midlands Setting Professional Modifier None Typical Low $2.88 Median $2.88 Typical High $2.88 | Professional | None | $2.88 | $2.88 | $2.88 |
Midlands Setting Professional Modifier None Typical Low $2.40 Median $2.40 Typical High $4.68 | Professional | None | $2.40 | $2.40 | $4.68 |
Sanford Health Plan Setting Professional Modifier None Typical Low $2.51 Median $2.63 Typical High $3.47 | Professional | None | $2.51 | $2.63 | $3.47 |
United Setting Professional Modifier None Typical Low $0.87 Median $1.05 Typical High $2.19 | Professional | None | $0.87 | $1.05 | $2.19 |
Wellmark Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Professional | None | $2.14 | $2.14 | $2.14 |
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 $0.89 Median $0.89 Typical High $0.98 | Professional | 52 · Reduced service | $0.89 | $0.89 | $0.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.36 Median $0.36 Typical High $0.39 | Professional | 53 · Discontinued | $0.36 | $0.36 | $0.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.27 Median $0.27 Typical High $0.28 | Professional | 55 · Aftercare only | $0.27 | $0.27 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.18 Median $0.18 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.18 | $0.18 | $0.19 |
Where South Dakota sits
The same service costs 2.6 times more in Hawaii 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· 15th of 51
$2.19
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.