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 $15.85 Median $15.85 Typical High $15.85 | Facility | None | $15.85 | $15.85 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $14.79 Median $16.98 Typical High $18.20 | Professional | None | $14.79 | $16.98 | $18.20 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $21.88 Typical High $24.55 | Professional | None | $17.78 | $21.88 | $24.55 |
Medica Setting Facility Modifier None Typical Low $14.79 Median $28.84 Typical High $28.84 | Facility | None | $14.79 | $28.84 | $28.84 |
Medica Setting Professional Modifier None Typical Low $13.49 Median $28.18 Typical High $165.96 | Professional | None | $13.49 | $28.18 | $165.96 |
Midlands Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
Midlands Setting Professional Modifier None Typical Low $17.78 Median $26.30 Typical High $32.36 | Professional | None | $17.78 | $26.30 | $32.36 |
Sanford Health Plan Setting Professional Modifier None Typical Low $16.98 Median $20.89 Typical High $30.20 | Professional | None | $16.98 | $20.89 | $30.20 |
United Setting Professional Modifier None Typical Low $13.49 Median $23.44 Typical High $33.11 | Professional | None | $13.49 | $23.44 | $33.11 |
Wellmark Setting Professional Modifier None Typical Low $35.48 Median $40.74 Typical High $40.74 | Professional | None | $35.48 | $40.74 | $40.74 |
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 $8.32 Median $8.51 Typical High $8.51 | Professional | 52 · Reduced service | $8.32 | $8.51 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.31 Median $3.47 Typical High $3.47 | Professional | 53 · Discontinued | $3.31 | $3.47 | $3.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.57 Typical High $2.57 | Professional | 55 · Aftercare only | $2.51 | $2.57 | $2.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.66 Median $1.70 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.66 | $1.70 | $1.70 |
Where South Dakota sits
The same service costs 2.8 times more in Alaska than in Louisiana. 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· 10th of 51
$23.99
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.