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 $10.72 Median $10.72 Typical High $10.72 | Facility | None | $10.72 | $10.72 | $10.72 |
Aetna Setting Professional Modifier None Typical Low $7.94 Median $7.94 Typical High $9.77 | Professional | None | $7.94 | $7.94 | $9.77 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $18.62 Typical High $18.62 | Professional | None | $9.77 | $18.62 | $18.62 |
Medica Setting Facility Modifier None Typical Low $13.18 Median $13.49 Typical High $21.88 | Facility | None | $13.18 | $13.49 | $21.88 |
Medica Setting Professional Modifier None Typical Low $5.89 Median $10.96 Typical High $74.13 | Professional | None | $5.89 | $10.96 | $74.13 |
Midlands Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
United Setting Professional Modifier None Typical Low $4.57 Median $6.76 Typical High $12.30 | Professional | None | $4.57 | $6.76 | $12.30 |
Wellmark Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Facility | None | $20.89 | $20.89 | $20.89 |
Wellmark Setting Professional Modifier None Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | None | $20.89 | $20.89 | $20.89 |
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 $3.98 Median $3.98 Typical High $4.90 | Professional | 52 · Reduced service | $3.98 | $3.98 | $4.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.58 Median $1.58 Typical High $1.95 | Professional | 53 · Discontinued | $1.58 | $1.58 | $1.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.20 Median $1.20 Typical High $1.48 | Professional | 55 · Aftercare only | $1.20 | $1.20 | $1.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.79 Median $0.79 Typical High $0.98 | Professional | 56 · Pre-op care only | $0.79 | $0.79 | $0.98 |
Where South Dakota sits
The same service costs 46.8 times more in New York than in Arkansas. 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· 5th of 51
$13.49
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.