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 $6.03 Median $6.03 Typical High $6.03 | Facility | None | $6.03 | $6.03 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $5.13 Median $5.62 Typical High $6.17 | Professional | None | $5.13 | $5.62 | $6.17 |
Cigna Setting Facility Modifier None Typical Low $12.59 Median $12.59 Typical High $15.49 | Facility | None | $12.59 | $12.59 | $15.49 |
Cigna Setting Professional Modifier None Typical Low $9.12 Median $9.33 Typical High $11.75 | Professional | None | $9.12 | $9.33 | $11.75 |
Medica Setting Facility Modifier None Typical Low $5.62 Median $9.55 Typical High $9.77 | Facility | None | $5.62 | $9.55 | $9.77 |
Medica Setting Professional Modifier None Typical Low $3.31 Median $4.07 Typical High $40.74 | Professional | None | $3.31 | $4.07 | $40.74 |
Midlands Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $9.12 | Professional | None | $9.12 | $9.12 | $9.12 |
Midlands Setting Professional Modifier None Typical Low $7.59 Median $7.59 Typical High $14.79 | Professional | None | $7.59 | $7.59 | $14.79 |
Sanford Health Plan Setting Professional Modifier None Typical Low $7.76 Median $8.32 Typical High $10.96 | Professional | None | $7.76 | $8.32 | $10.96 |
United Setting Professional Modifier None Typical Low $2.75 Median $3.31 Typical High $6.92 | Professional | None | $2.75 | $3.31 | $6.92 |
Wellmark Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $6.76 | Professional | None | $6.76 | $6.76 | $6.76 |
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 $2.82 Median $2.82 Typical High $3.02 | Professional | 52 · Reduced service | $2.82 | $2.82 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.12 Median $1.12 Typical High $1.23 | Professional | 53 · Discontinued | $1.12 | $1.12 | $1.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $0.85 Typical High $0.91 | Professional | 55 · Aftercare only | $0.85 | $0.85 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.56 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.56 | $0.56 | $0.62 |
Where South Dakota sits
The same service costs 2.6 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· 12th of 51
$6.92
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.