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 $1.78 Median $1.78 Typical High $1.78 | Facility | None | $1.78 | $1.78 | $1.78 |
Aetna Setting Professional Modifier None Typical Low $1.66 Median $1.66 Typical High $4.79 | Professional | None | $1.66 | $1.66 | $4.79 |
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 $2.69 Median $3.02 Typical High $3.72 | Professional | None | $2.69 | $3.02 | $3.72 |
Medica Setting Facility Modifier None Typical Low $2.82 Median $2.82 Typical High $4.57 | Facility | None | $2.82 | $2.82 | $4.57 |
Medica Setting Professional Modifier None Typical Low $0.98 Median $1.23 Typical High $12.30 | Professional | None | $0.98 | $1.23 | $12.30 |
Midlands Setting Professional Modifier None Typical Low $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Midlands Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $4.37 | Professional | None | $2.24 | $2.24 | $4.37 |
Sanford Health Plan Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $3.24 | Professional | None | $2.45 | $2.45 | $3.24 |
United Setting Professional Modifier None Typical Low $0.81 Median $0.98 Typical High $2.04 | Professional | None | $0.81 | $0.98 | $2.04 |
Wellmark Setting Professional Modifier None Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | None | $2.00 | $2.00 | $2.00 |
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 $0.83 Median $0.83 Typical High $0.91 | Professional | 52 · Reduced service | $0.83 | $0.83 | $0.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.33 Median $0.33 Typical High $0.36 | Professional | 53 · Discontinued | $0.33 | $0.33 | $0.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.25 Median $0.25 Typical High $0.27 | Professional | 55 · Aftercare only | $0.25 | $0.25 | $0.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.17 Median $0.17 Typical High $0.18 | Professional | 56 · Pre-op care only | $0.17 | $0.17 | $0.18 |
Where South Dakota sits
The same service costs 4.6 times more in Rhode Island 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
$2.14
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.